Your Labs Look Fine. So Why Don't You? Thyroid Health & Hashimoto's with Ryan Monahan

Welcome back, Synergy listeners. We are so excited to have you here today. Today we're going to be talking about one of the most common and often one of the most confusing conversations we have in our practices, and that's thyroid health. Maybe you're exhausted no matter how much you sleep. Maybe you're gaining weight even though you haven't changed what you're eating. Maybe you're cold when everyone else is comfortable. Your hair is thinning. Your brain feels foggy. Your digestion has slowed down, or you You simply don't feel like yourself anymore. So you finally have your thyroid checked and you're told everything looks normal. But if we're not looking at the whole picture, unfortunately, we're not going to see the real thing. So our guest today knows firsthand how frustrating that can be. Ryan Monahan is a functional diagnostic nutrition practitioner, nationally board-certified health and wellness coach, and microbiome clinical science practitioner, certified AIP coach, and founder of the Mindful Nutrivore and Functional Fast Track. But Ryan's expertise in thyroid health It didn't begin with a certification. It began with his own story and his own health. And today we're going to get to dig into that with Ryan and really understand a little bit more about thyroid health, what to look for, why it is so confusing out there, why are people being misdiagnosed. And listen up, grab a pen, paper, grab your favorite drink and join us today for a great talk. So, Ryan, welcome. Welcome to the Senergy Podcast. We're so excited to have you here today. Thank you.

Thank you so much for having me.

Yeah. So, Ryan, as we kick this off for our listeners, I think it would be really impactful for them to hear your story because I know that there are people sitting out there struggling with all of the symptoms that you experienced and they're being told, hey, everything's fine, and they really don't know what to ask for. They don't know what to look for. So I think you sharing your story will help them kind of navigate.

Yeah, I would love to share my story. So things really started to go south for me around my freshman or sophomore year of college when I started to experience some fatigue and depression and brain fog and some GI symptoms as well thrown in there too, some constipation issues. I really wrote off a lot of it, just attributed it to burning the candle at both ends. I was in college and I had a full course load and I was working a part-time job on the weekends. I was also a touring musician at the time. Actually, my My undergraduate degree was in music. So I really did push myself really hard and probably didn't help that I was getting maybe 4 or 5 hours of sleep a night on average, which is doing nobody any favors. Right. And so I had started to notice that I wasn't able to wake up in the morning without setting multiple alarms. So it started to get to the point where I was having to set 3 different alarms. And I would even set one in an adjacent room. So I would have to physically get up to turn off the alarm. Otherwise I wouldn't wake up for class in time. I would be late. Right. And I didn't, definitely didn't want to do that because I was paying my own way through college and I was taking it really seriously. That should have been a huge red flag though, because I was really running on sheer willpower for many, many years. And these symptoms continue to get progressively worse over the years with the chronic fatigue, the brain fog, the depression. There were days in my early 20s— now if I fast forward a little bit after I graduate from college— where I'm sleeping 12, 14 hours a night and it's still not alleviating the fatigue. I'm still waking up completely exhausted. Staring at the ceiling, wondering how I'm going to get through the day. So most of these days in my 20s, I was sort of like rationing my energy. Maybe I can, if I'm lucky, I can knock out an email today or brush my teeth or cook myself a meal. That was like a good day. And looking back, I often, I can't help but feel this was a lost decade for me. These were supposed to be what people describe as the best years of your life. And for that entire decade of my 20s, it was spent trying to figure out what was going on, this mystery illness, jumping from doctor to specialist to specialist, each with their own point of view, but with really no concrete answers. And I had a very, very poor quality of life. I couldn't work full-time because the chronic fatigue was so bad. Another layer on top of this is I had debilitating allergies to the point where most days I couldn't breathe through my nose. And even antihistamines wouldn't alleviate this, nasal sprays. The, the only thing that would open me up would be steroids. Prednisone is the only thing that would actually allow me to be able to breathe. Wow. So I was just walking around constantly sneezing, sniffling, Scratching my eyes out, just clear mucus running down the front of my face, and that was even you know from a social perspective that was really embarrassing. So then that added the social dimension where I'm kind of secluding myself, and I'm I'm turning down plans to go spend time with friends because I don't have the energy to do it. So it was a very very poor quality of life, and unfortunately it took me. I think far too long to figure out what was actually going on.

So I'm kind of curious, with the efforts that you made to get yourself help with providers, like, what were they? What were the— what was the path you were being led down as far as answers? Yeah.

Oh my gosh, I was told all kinds of crazy things. One GI specialist I went to for, for the constipation and GI issues, I was only Going to the bathroom every 3 days, which is— that's really not good for a lot of reasons, right? He told me, you just need to eat more Raisin Bran. That was what he— that was his actual advice. Now, this was around— I was maybe 25, 26 at that age. Another specialist told me I just needed to lift more weights. Not necessarily the worst suggestion per se.

Right.

But it was something clearly deeper going on, and I just didn't have even the bandwidth or the, the energy to even to do that.

Yeah.

Right. So, and a lot of people with autoimmunity experience this where they, they have that post-exercise fatigue or malaise, and they find it really hard to kind of get that momentum going. So I had been to a gastroenterologist, a rheumatologist, Several ear, nose, and throat doctors. I had been to a therapist because I I was depressed, right? I didn't realize that there was a very real physiological root there, but there there was that element to it. Gosh, I had been to a grand rounds at Yale New Haven Hospital, where I was living in at the time in Connecticut. So they had about forty doctors. Med students technically coming in the room one at a time with a clipboard, asking me questions, and as part of like their training, right? And so I'll never forget, I still have a printed copy of this report because the supervising doctor wrote, wrote a letter of his thoughts and summaries from that day. And he wrote the exact words where Ryan appears to be in good health. In other words, they couldn't come up with anything for this whole laundry list of mystery symptoms I was experiencing. And there were some other ones that too that were a bit odd. I had these granulomas on my hands and my ears. It's kind of weird spots throughout my body. I had some discoloration on my abdomen, like my skin color. There were certain patches that were lighter.

Hmm.

And that was diagnosed as periphericulitis, which now in hindsight, I think was probably autoimmune, like something like vitiligo. Yeah. It was just this merry-go-round of getting tossed around by seemingly really intelligent specialists, well-intentioned, I suppose I would say, and no answers. So it was a decade of You know, well over 40, even maybe 50 different doctors or specialists. And to kind of tie into the topic for today, not a single doctor had ever tested my thyroid through all of this. Not even a basic, like just TSH, not even a basic thyroid panel that, that had never been brought up. It was never suggested.

Yeah. I can imagine, Ryan, when you received that report, what you felt, because that was definitely an investment of time and energy. And I'm sure you went into that with such hope that there would be answers for yourself.

I really appreciate you saying that because I remember that meeting really distinctly. This was actually a TCM, a traditional Chinese medicine doctor. So the doctor number 51, maybe let's call it, right? And that's interesting, isn't it? Because it took me visiting someone a little bit more outside of the conventional system, maybe to look at things a little bit differently. And it was the first time I approached things a little bit differently. In that meeting with him, I came close to begging him to help me. Oh, wow. Like I was that desperate at that point, and I told him I knew intuitively something is wrong. Like this is not normal. This is not just aging. I'm I'm also at this point wearing sweaters in you know ninety-five degree Atlanta weather, and people are looking at me like are you crazy? I'd be freezing cold in the in the middle of spring or summer in Georgia. Subtropical climate. And I lay this all out for him. I tell him to, to really please listen. I asked him to listen because I felt like I wasn't really being heard or acknowledged. And he was very quiet, attentive. He told me, you know, we're going to do our best to try to figure out what's going on. Let's run some blood work and see what comes up and take it from there. Take it from there. He calls me on the phone, I believe it was the next day, it was pretty quick, and said, I know, I think I know exactly what's going on here. And I go, well, you know, please tell me. And he says, you have Hashimoto's disease. And I have no idea what that means. Right. This was not the path, by the way, at this stage in my life. Now I'm in my late 20s. I was still a touring musician at this time, and I wasn't— my degree was in music. That was the path I had set for myself since I was 10 years old. That was my dream. And so, boy, did that change everything, because that moment was this, this dividing line of everything in my life before and everything after that diagnosis. And it was confusing and relieving. And it felt like a huge weight lifted off my shoulders all at the same time.

Did you believe him at the start though? Because you had gone so many places, right? And they had attempted to, but they didn't have answers for you, right? They basically said you were fine. Everything was good.

I did. Yeah, I did believe him because it was the first time there was a definitive diagnosis. No one had ever put a name to it. And the way he explained it, he said, well, Hashimoto's, it's a scenario in which your immune system is attacking your thyroid gland, and because of that physical damage to the gland, it's slowing down your hormone, your thyroid hormone production specifically, and that's slowing down your whole metabolism. It's like putting the brake pedal on your entire metabolism. And so that's— Yeah. There's the fatigue, the brain fog, the depression, the cold intolerance, the constipation, like all of it.

And the depression.

That's right, 100%. And I wish more people understood that.

Yeah,

because that went away very quickly as soon as I went on thyroid hormone. And that was a powerful lesson to see how, how profound these hormones impact our body. how much of a profound physiological impact they have. And I do not discredit whatsoever life circumstances and how those can play into our mental and emotional health. But I think it's very much overlooked and underappreciated just how something like as simple as thyroid hormone can play into that.

Absolutely. We always say to anyone presenting with depression symptoms, and for our listeners out there, I will speak to you, if you're presenting with anxiety and depression, Assessing your thyroid hormone should be top on the list. You know, that's a non-negotiable. That needs to happen. I mean, this should have never happened to you, Ryan, and I'm so sorry in medicine that it did because that is the number one thing that should be checked if someone's presenting with depression and anxiety is a comprehensive thyroid panel.

Right. Because in traditional medicine, yes, in traditional medicine, you know, it's Typically, what we were taught and trained in school is just a TSH and a T4. And the reality is, is that you have to look at the thyroid as a whole. And to discern autoimmunity, it requires that you look at antibodies. Do you mind me asking, what were your levels at that point? Curious.

That's, that's the most traumatic part of the story. So first I'll start with a little bit of a reference point for your listeners who aren't familiar. So, so TSH stands for thyroid stimulating hormone, and it's actually produced by your pituitary gland, not the thyroid itself. And the job of that thyroid is to sort of kick the thyroid into gear, right? So if the thyroid is slowing down, then the pituitary can make more TSH to stimulate the thyroid back into action to making that thyroid hormone. So I like to say it's an inverse marker, and what that means is that when your thyroid is slowing down, TSH will rise. Typically, there are weird exceptions, right? And if your thyroid is too fast, then TSH will come down. So when you're looking at a lab report, you're usually going to see TSH about 0.5 to 4.5, like from LabCorp. That's pretty Pretty spot on. In the kind of holistic functional world, we like to see that even more narrow, like 0.5 to 2.0, 'cause we wanna be proactive, not reactive, right? So the range is a little bit tighter there. Okay, so keeping that in mind, my TSH when I was diagnosed was above 150.

Wow. So your pituitary was screaming at your thyroid, help, help, help, we need more hormone.

Yeah. It was screaming at my thyroid to wake up. And, and what's even more shocking is the lab report actually had the greater than symbol. And the doctor I was working with, he explained, well, the lab, it tops off, it can't go any higher than 150. So it could have been 151, it could have been 300, right? So, you know, if you do the math, if you're using, you know, 0.5 for TSH as the lower limit, that's You know, 300— I think I have that math right— you know, 300 times above.

Yeah,

that range.

A lot. It's super high.

Super high. And I don't see that often, you know, not that it's a competition, but even, right, if I see it at a 10, I'm like, whoa, that's really high.

Well, it's not a new problem. That wasn't a new problem. And I think what's really sad about the situation and the reality of the situation is that it was never checked before. So it took you a while to get there. Um, and all the while the body was completely disrupted all— I mean, hormonally, metabolically, the entire time in that. What were your antibodies like?

Yeah, my thyroglobulin antibodies were the higher number. They were around 1,200, and the TPO, thyroid peroxidase antibodies, were not exceptionally high. They were maybe 40, give or take. It was, you know, that's interesting because for, for the most part Usually when people receive a Hashimoto's diagnosis, it tends to be the other way around. It's usually TPO antibodies that are high and the thyroglobulin antibodies are maybe mildly higher or not even elevated at all.

We see the cascade of it. So from that point forward at that visit, what were the recommendations for you to do? Was it just about taking the thyroid medication or were there other recommendations at that time that this practitioner said would be important in addition to taking meds?

So, the TCM that made that diagnosis, he referred me out to an endocrinologist so that I could get on thyroid hormone. So, that was the next step. And, I saw the endocrinologist, we ran another thyroid panel just to kind of confirm things, and he put me on Synthroid, which is synthetic thyroid hormone, T4 only. And I will admit that was a game changer pretty much overnight. Like, I was a different person and I wasn't exactly sure what to expect. Like, maybe this will take a week or 2 or a month to kick in. And wow, like the next morning, I, I still remember because I woke up with the sunrise without an alarm, like 6:00, 6:30 AM. For the first time I can remember since I was a kid. And, I just had this pep in my step. I remember the brain fog lifting, having more energy, mental clarity. I was starting to actually be able to go to the bathroom every day. It all happened very quickly. Yeah.

So, I'm curious to know, did anyone look at your adrenal function during that time as well? Because I do find that there's a correlation between having thyroid conditions and adrenal conditions that come And sometimes when we add that thyroid hormone, you feel good initially and then you crash yourself out because the adrenals were not properly worked up or assessed. So just curious if that was part of your story.

You know, not initially. That was something I came across many years later once I became a functional practitioner myself and started running hormone panels and learning the DUTCH test, for example, and those cortisol patterns and how to assess adrenal function. That initial endocrinologist, it was a very limited experience. He was basically just there to test the number and prescribe. In fact, I remember because I was doing a little bit of reading at the time, and I remember asking him if we could run reverse T3 and thyroid antibodies. And if— and I asked him as well if there was anything that could be done from a diet or lifestyle perspective. So in regards to running a full thyroid panel, he told me exact words that that would be a waste of your money.

Yeah, sadly that is too commonly heard.

Yeah, well, from the conventional perspective, you sort of can't blame them. The, the only thing that you could do to manage a thyroid issue or thyroid condition is to, is to take synthetic or, or, you know, thyroid hormone. Replacement, which that could not be more wrong. I think that's why we're here today to talk about that. Yeah.

Yeah.

And I'm glad I eventually did come across a doctor that that was more than willing to run a full thyroid panel, and he happened to be an integrative doctor and was well versed on those optimal ranges. And so it was a journey, and and that that's one important message for your listeners too: that sometimes you really do. Need to be an advocate for your own health, and with this particular endocrinologist, after he told me it would be a waste of my money, I just never went back. I didn't accept that. Said, "Well, you're fired," right? Move on. You find someone who's gonna give you the care and attention that you deserve, and and that that same to end on another thought. That same endocrinologist also told me, don't bother with the diet and the lifestyle stuff. There's no evidence behind that. And really, really sort of poo-pooed it.

Right. So we think about hormone balance, especially thyroid hormone balance, we think about production, and you obviously had a production problem. You were not producing thyroid hormone. Those follicular cells had been damaged for too long for you to be able to produce thyroid hormone, and you definitely needed thyroid hormone adjunctive care. But then we think about conversion. Can we convert that T4 over to T3 to be intracellularly driven and metabolically active? And that happens in the liver and the gut. So gut health is important. Liver health is important. And then we think about driving that hormone into the cell. Proteomics. How does it get into the cell? And if there's a lot of inflammation, that doesn't happen either. And so there's all kinds of opportunities for thyroid hormone to become dysregulated beyond just a production problem. Right.

Very well said. And this is where I tell my clients all the time that thyroid conditions are a whole body problem. Hashimoto's, hypothyroidism, it's not a thyroid problem, it's a whole body problem. So we have to address it that way. And what you just alluded to is what I like to call the thyroid hormone journey. So it starts with that production of thyroid hormone in the thyroid gland, But your thyroid really only makes T4 and some trace amounts of T3. It's like a, a T4 thyroid hormone factory, but we need it to be in the T3 form in order for it to be biologically active, as you said. Where does that conversion happen? It happens in the liver. About 70 to 80% of that conversion happens in the liver. So that has nothing to do with the thyroid. Yeah. Right. So it's almost like this assembly line process. We make that thyroid hormone in the thyroid and we need nutrients like iron and iodine and tyrosine to be able to do that. And then we convert it into T3 in the liver. And then finally, that thyroid hormone has to make its way into our cells. So the final step is that cellular reception. And that thyroid hormone is only as good as your ability to utilize it. Right. So you could be making the thyroid hormone, converting it well into T3, but uh-oh, now your cells are shut down because there's a cell danger response,

right?

And you're not, you're not taking in that T3. And this is where you can have a very optimal-looking thyroid panel on paper and still have the fatigue, brain fog, depression, hair loss, weight gain, and low libido, you name it. And so I know there's a lot to unpack with.

Yeah, but we see that all the time, Ryan, in our practices. I mean, we, we're witness to that oftentimes. We, we do get their labs back, or maybe they bring in labs to us that they've had done somewhere else, and they're like, I'm being told my labs are fine, but I do not feel fine. And so, as you mentioned, it is a whole body problem, especially Hashimoto's, because we know that's an autoimmune condition. And so if we don't deal with the immune system, then we oftentimes can go on Not only to not feel well with Hashimoto's, but to develop other autoimmune conditions. And so it's really important that there's a conversation with your providers on what do we do to help balance that immune system, right? Not suppress it, but balance it in a better way.

That's so important because once you have one autoimmune condition, the odds go up 25%, the likelihood that you'll develop another autoimmune condition. So if you're not addressing that underlying inflammation and immune dysregulation, and you're like, let's say you're only supporting it with thyroid hormone replacement, you're really just papering over the symptoms and not actually getting deep enough. And so then that fire is persisting underneath the surface and it's spreading. Yeah.

So I'm curious with your story, because a lot of the times the journey that we go on is Helping patients determine what are their drivers for autoimmunity. And so what— I mean, obviously you were in college, you probably weren't eating that well, you were not sleeping, so your metabolic stress level was up. But were there other things like heavy metal exposure or mold exposure or anything else that you felt like drove that immune system in that direction?

All of the above. Okay. And in college, I'll admit it was an ultra-processed food diet. You know, Kraft mac and cheese, Krispy Kreme donuts, just, you know. Gluten heavy. Yeah, gluten heavy. Yeah. Well, well, okay, so here's another interesting piece of the story. My first job as a teenager, starting at age 15, was working at a local family-owned pizza restaurant, and we would make our own pizza dough with high-gluten flour. It was specifically high-gluten flour Because it gives the dough that elasticity. So, I had worked there on and off, even through college, summertime vacations, that sort of— on breaks, I would come back. I probably about 7 years on and off, where what was I eating every night at the restaurant? Pizza.

And inhaling all of that gluten too. I mean, let's face it, it was in the air. Like, you were not just eating it, you were inhaling it too. So, yeah.

Lovely mucous membranes that people think about, right?

Yeah. And causing all that intestinal permeability. Every time I'm eating that gluten, it's like causing a little tear in the gut lining. So, you know, it, but it was many, many years before I would realize the link between any of this. So a lot of antecedents there for sure. My mother smoked cigarettes in the home when I was a child growing up.

So for our listeners, that's cadmium exposure. So that's a heavy metal exposure. Yeah.

Yep, exactly. Which can be major thyroid competitors, you know, competing with thyroid hormone and thyroid hormone uptake. So after college, uh, at this point in most of my 20s, I was living in North Georgia and mostly in Athens, Georgia. And when I was 25, I bought my first home. And so I was living in this home that was built in the 1930s, really old home. Had a very musty smell. And I, I knew this from day one, but I didn't, I never thought much of it. Just, oh, that's how old homes just have this musty smell. You know, coincidentally, or maybe not so much coincidentally, I was diagnosed with Hashimoto's when living in that environment. It was extremely moldy. It took me until about the 8th or 9th year living there to figure that out, um, through doing some environmental testing in the home that showed mold levels just out of control. Out of control. So you know if the Hashimoto's came before or after that, I'll never know because I didn't figure it out until I was 28 when I had that Hashimoto's diagnosis. I'd been living in that home for about three years already at that point, but it was still another five years before I even put two and two together with the mold issue in the home just because that's not. Talked— it's talked about a lot more now.

Sure.

And it was then, but there was just nothing. Nobody was talking about mold then. So I— something I had just no awareness around.

Yeah, mold does interesting things to the body, and creating that inflammatory autoimmune burden is one of the things that it can do, for sure.

Very much so, 100%. Yeah, yeah, those mold toxins are some of the most inflammatory chemicals that you can possibly get exposed to. And they're, they're intensely immune suppressive. So they're causing all kinds of metabolic chaos, right? Not to mention they're— these mold toxins are so incredibly tiny on a micron-level scale that they can easily cross your cell membranes and cross your blood-brain barrier. So they're just kind of permeating in all of the little nooks and crannies of your body and just causing inflammation everywhere.

And then we think about other triggers that you may or may not have had, but we think about people who have had concussions, they've been in contact sports, which has led to intestinal permeability, people that have been on multiple antibiotics for different reasons, infections, highly processed foods with lots of food coloring. Like, those are additional insults. For those listening, you may not have had those, but those can be additional insults to that gut wall lining, losing that that tight junction, if you will, leading to leaky gut and driving the immune response. I do want to go back for a second. You know, when we were talking about lab work, there are times where we will also see individuals who have a normal TSH. Again, you know, difference between reference range and optimal range, but Yeah. Sometime within that normal range, but their antibodies will be elevated. And I think it's really important to think about that subset population too. I know that that wasn't you, but they are often discounted and they are not looked at. They're told they're fine too. And the reality is they're already having autoimmune reactivity. They may not have tipped the threshold for a diagnosis of Hashimoto's, which is an elevated TSH and antibodies. But they are already having autoimmune reactivity, and it's a signal engine lights going off too. Have you seen that in some of the people that you've worked with?

I see that a lot, and it really should be viewed as an early check engine light. Once you're starting to produce those antibodies, there's already a fire that's starting. And, you know, maybe that fire is a little bit smaller and contained, but what's the nature of a fire? It spreads. This is why the word flame, right, is an inflammation. So what you just described, sometimes this is called subclinical hypothyroidism or euthyroid Hashimoto's. There's different ways to kind of categorize it, but I like to think of it as a spectrum. And so someone with a normal TSH but elevated thyroid antibodies, they might be lucky in a sense that They're catching it early on in the process before those antibodies have resulted in enough accumulated damage that it's then actually causing your thyroid hormone levels to drop and your TSH to rise. But if you don't intervene early, that is close to inevitable, or at least highly likely. And I wouldn't want to roll the dice and say, well, You know, TSH looks normal and the thyroid hormones look normal. It's like, no, there, there's a, the beginning of an autoimmune process going on here. And so let's, let's dive in. Let's, let's take a look at your labs. Let's look at your gut health. Let's clean up your diet. And when we do those things, yeah, we can see a rapid turnaround sometimes of those antibodies coming down with simple interventions like going gluten-free or just, you know, supplementing with selenium. For example,

yeah. So I think it's a myth. Oftentimes patients will come into us with elevated thyroid antibodies, and they've been told those antibodies don't check them again because they're always going to be positive; they'll never change. And I've seen time and time again, right? Working them through the process of learning what's driving the inflammation and correcting for that, and those antibodies can normalize. Doesn't always happen, but it can happen. And I think working toward helping patients understand the drivers is really where we. need to be spending our time and energy.

Well, I stand here in front of you two today, and I've gotten my antibodies down 96% from where I've started from that initial diagnosis. And with everything I've learned over the past decade, I've been able to help clients get their antibodies down, and in some cases by 80 to 90% in 3 or 4 months. That's not a guarantee that's always going to be the case for everybody.

Sure.

But I've seen it and it's possible. And if the numbers aren't moving, that's just a sign we need to keep looking, we need to keep digging.

That's right.

This thyroid dysfunction, it does not occur in a vacuum, it doesn't occur randomly. Yes, there may be a genetic component, but that's just a small part of the picture, and that there's something that triggered that to happen that is identifiable and modifiable. Meaning, like, we can actually implement some changes, sometimes simple ones, to move the needle.

And if we don't, then further hormone disruption ensues. And so, the sooner the better. So, I'd love to hear, in your experience working with, I would say, numerous people at this point, what are the most powerful lifestyle measures that a person can start that make a difference in relationship to Hashimoto's?

I like to say that the best place to start are with some of the simple things. Some of the simplest things that are oftentimes free are what can actually make the biggest difference, right? So where, where might I start? So first would be cutting out added sugars and ultra-processed foods. And removing gluten from your diet has been shown time and again to be One of the number one interventions for resolving the conditions that led to autoimmunity, and even in many cases seeing a drop in those antibodies. Optimizing your sleep, you know, that starts with getting sunlight within the first hour of waking to reset their circadian rhythm, ideally getting to bed by 10:00 PM, you know, having some kind of like wind-down routine. Sleep is where we do most of our DNA repair. It's where we do that glymphatic drainage from the brain. So there is a detox component to getting good adequate sleep. And many people with Hashimoto's, probably most of them actually, are loaded with toxins. They have a high toxic burden. Like we talked about mold and heavy metals as examples. There's a lot more, you know, pesticides, BPA, parabens, phthalates, right? So starting to— another one would be auditing your home environment, going onto a website like the Environmental Working Group, that their Skin Deep database, and, you know, starting to look at your cosmetics, your personal care products, your cleaning products, and, you know, seeing if there's endocrine disrupting chemicals in those products that could be actually disrupting your thyroid function. I would say investing in a high-quality water system, water purification, Just all these things we talked about, we can be getting exposed to simply through our drinking water. And that's just an easy, low-hanging fruit place to start, to start to kind of lower that toxic burden of what we're getting exposed to. You can take the dietary piece a little further and go more anti-inflammatory. Some people do well cutting out dairy, soy, grains. Even in some cases nightshades, more of like an autoimmune protocol style type diet. But I would caution that those eliminations are only intended to be temporary, you know, 2 or 3 months at most. I do see a lot of people removing entire food categories, often to their detriment.

Right.

Where people come to me, they've been on a very restrictive diet maybe for a year or 2 years. And all right, now it's not about removing, it's about adding back in.

Yes.

Getting that diversity to support your microbiome and to help rebuild your gut lining and all of those wonderful things, right? So there's, there's so many simple things we can do that, that are either no cost or low cost, you know, sunlight, clean air, clean water, community, joy, purpose, optimizing your sleep, getting some movement and exercise to, to your capacity or ability. And then there's this next layer where we can start to dig deeper with lab testing, right? So depending on where you're at with that, you know, working with a really skilled or knowledgeable practitioner can really make a difference. Um, if I knew about functional medicine at a younger age and what it could offer me, I would've signed up immediately. I would've had no hesitation making that investment. Someone who maybe has been through a similar journey that has that empathy and understanding. That can help you with that test, don't guess component of your health journey to help you actually identify what are your unique imbalances or triggers so we can bring the system back into balance.

I love that. So, I love that you have built a whole career around helping other people with, you know, with similar struggles that you've had. I think there's power in that. You can definitely tell there's empathy. In the way that you communicate and the way that you view the people that you serve. And so I just appreciate that. Lori and I both share that too. A lot of the things you were mentioning in your list of things to do are things we talk about all the time, like all the time.

Awesome.

And they're so important. They seem so simple and maybe trivial to people that are listening with naive ears, but they're so incredibly impactful in helping someone truly recover, not just feel better temporarily, but truly harnessing the beautiful power of the body to heal.

I like to say it's all— healing is all about aligning our biology with what our genes and our biology expect from us. If it's all right with you guys, I'd like to share a simple analogy that I like to use with my clients.

Sure.

And I like to say that we're not that different than a houseplant. Here's what I mean by that. So no one would disagree here, no one listening to this podcast, that when it comes to a plant, there are some basic biological requirements, necessities, prerequisites. That plant is going to need sunlight, it's going to need healthy soil, it's going to need water, it's going to need to breathe in some carbon dioxide, right? So it's almost like there's a, a formula of biological requirements for that plant. Mm-hmm. And so it's no mystery if you water your houseplant with Mountain Dew and you put it— shove it in the closet where it's not getting any sunlight, it's not going to thrive. It's going to die actually pretty quickly. That's not a mystery to anybody. But for some reason, humans, we like to think we can break the rules and we like to think that we're kind of above that, that we can— That, that there's not a biological code, but there is. Ours is a little bit more expanded and complex, but humans need to thrive. We need a healthy nutrient-dense diet. We need to— we need sleep, and we need to optimize that sleep in alignment with our biological rhythm, the circadian biology piece. We need movement and exercise. We need to manage our stress. That's something plants don't necessarily have to do. Maybe that's arguable, but, you know, right, we need stress management. We need to take care of our nervous system. We need communication and contact with other people. So we need community. And so these are what I view to be the pillars of health. And they might seem boring or trite. They're not sexy. I'm not talking about pills or peptides or even really supplements. That much. Those come after we have all of those really dialed in first. And that's where the magic happens. I have to tell you, after having been in practice for close to a dozen years now, having run over 4,000 labs, and often other practitioners come to me for, for that expertise, for the lab interpretation side. But even all that being said, I, I'm still here talking to you all about those basics, those foundations. Yeah, we can't, we can't deny them, just like the plant can't deny those, those foundations.

Ryan, we are in light company, and we honestly— people cannot hear this enough, and we can say it all day long in our clinics, but validating that From people that are in this every day, much like you are. It's that validation. You cannot bypass the foundation. You can't. And there's a lot of shiny objects out there, and we are thankful for the advancements in medicine that we have access to. We absolutely are. But these foundational principles are foundational for a reason. They're core principles for a reason. Our body needs all of those things. in order to live optimally. And so I'm glad you said it. Um, it's— and you said it in a very eloquent way. Like, you said it so well, um, so clearly. And really appreciating that because, you know, our listeners have heard it time and time again. But I mean, we're human, right? We want that fast-forward button a lot of times. We want the easy button. We want that. It's human nature to want that. But the reality is we can't Yeah,

we call those— the things that you mentioned, Ryan, we call those our non-negotiables.

They're non-negotiables.

You know, we may have to shift and pivot at times where we give more attention to one versus the other, but they're truly non-negotiable foundational pillars in leading a life that's going to allow your body to repair itself most of the time. You know, we're not immune to disease. Things can happen. But we want to give our bodies the best chance they have to thrive and to feel well.

I couldn't agree more. And one thing I'll add to that too is that those shortcuts almost always end up not being a shortcut.

No.

Or an expensive shortcut, let's just say.

Yeah, they end up costing you more time, more energy. Because why? Because they're not really supporting the foundations.

And we're experiencing So much of it now too with you know GLPs and and peptides and things like that. Like again, there are reasons why those things are tools in the toolbox, but that's what they are. They're tools in the toolbox to aid. They're not shortcuts because you do end up. It's it's it's not a sustainable plan either, and at the end of the day. You know, we are naturally those that like to have something done super quick and get to that result, like that finish line, like, woo, we're healthy, we're well. But we're dynamic beings. We have to shift and change, and there are no shortcuts.

There really are not. There are no shortcuts.

And the finish line, you know, we're all going to have a finish line. This I know. But, you know, there is no finish line to wellness. Truly, things are going to evolve and change over time, and we may need more of something at any given time or season in our life. And just being able to track and trend our progress, being aware— Lori and I are big Oura Ring users to help people track, right, like what's going on day to day, and getting them in tune with being more aware of the impact that the daily choices that they're making. What's driving what, right? So we find that the wearables can be very helpful there. And then tracking labs over time. You know, we encourage our patients to keep their lab work, to track and trend their labs over time, because you are the CEO of your body. Ultimately, you are who you're going to answer to when it comes to your health. And so it's important that we take it that seriously.

And no one can do the work for you.

No.

And that, that's one very difficult realization I came to after that Hashimoto's diagnosis. It was very sobering.

Yeah.

But it was that no one's coming to save me.

Yeah. So as we're finishing up today, we always like to ask a question. And thank you so much for being here before we get into the question, giving us your time. You are in like company. This has been a very powerful conversation that I know our listeners will enjoy. But we'd like to know, you know, as you sit here today, what is the one thing that has made the biggest impact on your health that you are doing currently?

Wow, that I'm doing currently. Well, I do love my Oura Ring. I just want to throw that in there.

Okay.

It's really nice to have that, you know, day-to-day feedback. Is that the number one thing? No, but it does help provide some you know, guidelines and some— it's like the bumpers at the bowling alley, right? It's keeping you in your lane. Mm-hmm. The number one thing that I'm doing currently, you know, I'm really grateful to be in a place where I've spent so many years doing the work, like really actually doing the work. So there's nothing that I recommend to my clients that I haven't done myself. And I'm now very fortunate to be in a place, you know, knock on wood, where I don't have many chronic complaints or symptoms to complain of. And I've been able to successfully put that Hashimoto's into remission. And so my day-to-day now is really about maintaining that. Like you said a moment ago, once you heal, your work is not done. Like I tell my clients when they get, when they get that retest back for a lab report or a gut test, and it comes back looking like an A+, and they ask me, now what? I say, well, you don't earn a diploma here. You don't earn a diploma for healing your gut, right? It's because as soon as you go back to living the way you were before, it's all going to break down again. So, it is not just about following those kind of biological laws that I talked about. Now, we have to stay on that course for the rest of our life. I mean, we don't have to. No one has to do anything. But, if we want to maintain what we have built and we want to stay healthy.

That is right.

So, there really is not one single thing. For me, I like to tell my Clients, be boring and be consistent. I love it. It is really about all these little things that I do. My daily routine, I wake up, I may do some little bit of breathwork. I go outside and walk the dog, so I'm getting some exercise, I'm getting some sunlight in my eyes. I might do a little bit of gratitude journaling and writing down my to-dos for the day. Take my— all my supplements with breakfast. Gonna make a really healthy breakfast with some leafy greens, maybe some turkey sausage, maybe some bone broth. Right. And of course, I could— I don't want to take up the whole time with my daily routine, but you kind of get some examples.

People like to hear it, so it's

okay. Okay.

I'm curious, Ryan, with your Oura Ring data, did wearing the device change anything about your daily routine once you had the data? Like, how did it help you dial things in, or did it help you? Were you already dialed in when you started wearing it? I'm just curious.

Not to toot my own horn, but I feel like I was pretty dialed in already on the sleep side. Like, I'm— I consistently— my average bedtime according to my Oura Ring is around like 9:00, 9:30. So I'm really pretty very diligent about that and rarely break that timeframe. And so, yeah, what is the Oura Ring? Here's my Achilles heel. So I'll open up to you all. Because, and I think that's important.

We all have one.

We all have one. Even practitioners, health coaches, right? Nobody's perfect. My weakness is with— I work a very full schedule, sometimes weekends, because I'm also writing a book, which I'd love to tell you guys about. But mine is on the exercise side. There are definitely days where I do not hit my activity goal, and it will tell me. And that that has helped me to remind me that I need to get up and move more, even find little ways in between calls with clients, doing some body squats, doing another afternoon walk with the dog if I can, or getting out there and throwing throwing the ball with the dog. What you know, it's reminded me to prioritize it more that I need to. I love yoga, so. It's reminded me to, you know what, my health comes first. I can't help other people if I'm not filling my own cup. So having that Oura Ring data, it did remind me to schedule, you know, a weekly yoga session that I go to in person. So now that's in my schedule. And so that's one way that it actually has helped me modify.

I love it. I love it. So tell us about your book.

Yeah, so I'm writing a book on my journey with Hashimoto's, and it's also going to be a bit of a manual, a how-to manual on how to be a self-healer. And it's gonna include all of the protocols and suggestions that I implement with my clients. The only thing that it can't do for you is the lab testing. But aside from that, it's, Really holding nothing back. It's sharing everything I've learned over my years of working with people with Hashimoto's and other autoimmune conditions.

When does it come out, Ryan?

Yeah, so I'm— I finished the book. I'm in the editing process now, about halfway through the revision process. So I'm really hoping that it will be finished by November, December. Then, then comes the whole, you know, marketing.

Marketing, yes.

That's a whole nother side of it. So we're looking at definitely a 2027 release for sure. Not exactly sure the date, But it will be out next year. So I'm really excited.

I'm sure once it releases, you'll be busy too, getting it out there and getting— yes, that's awesome.

We're excited for you. Okay, so we have to just go back just as we're closing. So what's lunch and dinner like? Because we can't start the day and not finish.

I only eat 2 meals a day. I usually eat a pretty big breakfast, and then I, for lunch, I'll have like a lighter snack. That could be maybe something with some veggies and guacamole or some hummus or like a hard-boiled egg, something like that. And yeah, so I'm big on breakfast and dinner. I do, I do 2 meals a day, which is kind of like intermittent fasting, but not, not quite.

Well, you're doing a snack in between, so you're having 2 meals and then a snack in between.

So yeah, and you know, those with Hashimoto's typically do better with having some, you know, regular food or meals throughout the day to keep that blood sugar stable, getting some protein in there regularly, getting the fiber. It's really important. And so, yeah, dinner too. I know what we're making tonight. I'm going to make some grass-fed beef, some grass-fed beef burgers with sweet potato and pecans. Very fall dinner. Yeah. And Brussels sprouts.

Yummy.

That's going to be on the menu tonight.

All right, you're making me hungry. Thank you again so much for your time. We are so excited about this. Um, can you leave us with a way that people can get in touch with you should they wish to hear more about you?

So you can find me at themindfulnutrivore.com. You can find me at— on Instagram @themindfulnutrivore. You're welcome to send me a DM there. And I also do have a free Hashimoto's Ebook, if anyone was interested, I'd be happy to share the link with both of you to share with your audience. That's going to be like a little bit of an appetizer to the book, and and that will also get you on the mailing list so you can get updates about the project as well.

Excellent. We'd love to have that, and we'll put it in the in the show notes as well.

Thank you. Appreciate that.

Absolutely. Anything we can do to support you, we would love to. You speak our same language, and we would definitely. We love that you're out there doing the work and you're leading the charge, and you've been doing it for a while. So keep doing what you're doing. Don't burn yourself out. We know you won't.

I try.

That's right. And and we would love to support you in any way we can. So keep us posted.

Thank you so much. I appreciate you both so much. You're so kind.

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