72: When Thyroid Care Finally Starts Listening - Why Personalized Treatment Changes Everything with Yari Tran Melody Volz and Nikki Abelow

So today's episode is going to be something a little different than you all are accustomed to. You all have recommended and asked for on so many occasions an interview with our clinicians, so we wanted to create an opportunity for you to get to know them, their journey in medicine, in thyroid, a little bit about who they are as people and what they love most about serving people with thyroid disorders. So This will be part 1 of our multi-part clinician interview series where we get to sit down and chat and just hang out and spend time together. So if you don't see your clinician here and you had hoped they were here, stay tuned because there will be more to come soon. Welcome to Modern Thyroid and Wellness, where we talk about all things thyroid, hormones, and honestly anything that can help you live a longer, more vibrant life. So really excited to introduce you to one of Modern Thyroid Clinic's longest clinicians, who's been here the longest rather I should say. And a quick tidbit about Miss Yadi Tran is she, like me, is a PA. And when I first graduated PA school many years ago. We're approaching 20 years soon.

You can't say it out loud, Nicole.

Right.

When I first graduated, she trained me in my first PA job. So we've actually worked together for the bulk of my entire career. She is an incredible human, mother. Patients love her at Modern Thyroid Clinic. So Yadi, welcome to the podcast.

Thank you. I'm excited to be here.

So obviously people listening know this serves as a way for everyone to get to know you a little bit better. So my first question is, what originally drew you into medicine and how did you end up passionate about thyroid care and at Modern Thyroid Clinic?

Oh wow. So what originally drew me into medicine, I've just always wanted to go into medicine. Like even as a child, I remember in kindergarten bringing my mom's anatomy and physiology textbook from her college courses to show and tell. So a little bit of a geek like that. So it was never like, what would I do, but more of what would I want, how would I want to work in medicine. And for the longest time it was medical school, but then like throughout undergrad and shadowing doctors and volunteering, I landed on physician assistant because I thought it was like a good mix and then still allowed for flexibility for family time. And then my journey into thyroid and hormones is like a long-winded journey, but I think it's really interesting. Like you, I started in neurosurgery and then moved into pain management. And interestingly enough, it was in pain management that I started learning about thyroid and hormones because the clinic that I worked with at the time was also trying to expand expand into what other ways could we help our pain patients. We had a lot of patients with like chronic fatigue syndrome and fibromyalgia. What were the other contributing factors to that? And I freely admit to being one of those providers who was like, oh hey, your labs look normal, it just has to be— it can't possibly be this. But I ended up going to a conference and it was very much like hormone based, and they did have a section on thyroid. And I remember sitting there and they were talking about T3 and how T4 medication can be ineffective, and conversion and reverse T3 and how it can present as chronic fatigue, fibromyalgia, and just going into more detail over like the extensive symptoms that a poor functioning thyroid can result in. I would have to say that was my eye-opening moment of, I remember sitting there thinking, oh my gosh, I have been so wrong for so long. And so that was a, I don't wanna say like a life-altering moment, but it was definitely like a career-altering moment. And then I started interacting and in a way viewing my patients differently where it was like, okay, what we're doing pain management-wise is helping in some areas, but you have these other issues popping up. Let's check labs, let's look at this. But then in a traditional clinic model, there's not enough time to cover all of that, right? When you have 15, 20 minutes for a follow-up patient. And then I remember just not keeping tabs on you, but what is McCall doing and what is she up to? And I know you were like starting to promote this idea that there's a better way to manage thyroid. And you were so gracious in letting me come shadow you on days where our schedules aligned and trying to take what I learned from you and applying it to the patients that I had at the pain practice. And then yes, it eventually moved over to I came and shadowed you like full-time, and then there was a position at the clinic. And so That's how it all started, was with a conference.

I love it. I love it. So my next question was actually going to be, was there a moment in your training or career when you realized that conventional thyroid care wasn't enough? But for you, would that be at that conference? Was that your aha moment?

It was definitely the aha moment. And then it was a couple of years of trying to make it work. Within the context of the practice that I was in, which is challenging because we're pain and that's the emphasis. And then you're also trying to do this in a way on the side. And I feel like I made some good progress with my patients, but I was also just still limited in my knowledge. And that's where you came in. I definitely had like trial and error on things, but not having the ability to really sit down and manage the thyroid that it needed to be done. And then we were still working within the insurance-based model of care that made it really difficult to do medications like desiccated thyroid and T3. Yeah, it's hard to do it within that framework.

It—

to do it well, I guess, is what I should say.

Exactly. And I think one that just brings to mind So many people who maybe are like functional medicine, or they look at thyroid in a little different way, they look at what we do and they think, oh yeah, I do the same thing. I use T3-based meds. I do a full thyroid panel. And I love that you aired a little bit of, hey, this is far more complex than most people recognize, and it's far too complex to do in a really short period of time or to master if you're doing all of these other things, because the one thing that we know at Modern Thyroid Clinic is thyroid conditions are incredibly complex. The treatment for them is incredibly nuanced, and it's more complicated than I think people who are maybe just outside of our periphery, clinicians even, still recognize.

It is. I wish it was as simple as, oh, here, let's just give you some T3.

Yep.

And we've seen the spectrum of just not enough T3 to like way too much T3. And it is, and it's very unique to each patient. Like they're not all the same. It's each one is very individual for sure.

And I get comments on my social media things that are like, I tried Armour and it didn't work for me. And I'm like, just because you tried a medication again, it's nuance. Like it's, it has to be the right med, the right dose at the right time.. It can't just be, here's some desiccated thyroid, your whole life should be better now. Or here's some T3, your whole life should be better. No, like it is so individualized and that's why y'all's clinical expertise and how you continue to grow, evolve, analyze data is so incredibly powerful and why I think we're able to change people's lives so much of the time so quickly.

Yes.

I will tell you my rookie mistake that even you were like, yadi, was taking a person who was on a high dose of levothyroxine. And just putting them on Armour, like trying to find that equivalent dose. Of course they did horrible on it, and I'm sure they were one of those patients that was like, I did Armour and it didn't work. I did it wrong, like not in the best way to support the patient. So yes, there is a ton of nuance there, right?

And what Yadi is referring to is the most common mistake that happens when someone outside of Modern Thyroid Clinic tries to get switched from a T4-based medication— levothyroxine, Synthroid, Unithroid, Levoxyl— all very long-acting T4 to desiccated thyroid that's much more short-acting, part of which hits the same day. And when you stop T4 on one day and you start the equivalent dose of desiccated thyroid the next day, you double their dose of medication because 100% of their levo-based med is still in their system. People get really anxious, really agitated, and they think they can't tolerate it when in fact they've just doubled their thyroid med in one dose. And really, no one can tolerate that. I remember literally probably 2014 when I— the first time I wanted to do that, I went to a pharmacy that's really high regarded here in Austin, a compounding pharmacy, talked to the pharmacist about the time, the change, and how that should best take place because of the differential and half-lives. And she literally just told me, you just switch them in one day. And I'm like, this isn't, this isn't right. Like, you're wrong. So it took us a long time, but that is definitely one of the most common mistakes, even that the functional medicine world hasn't caught up with. Yet. Okay, next question. What do you find most meaningful or fulfilling about working with thyroid patients?

I think the most meaningful and fulfilling is just the ability to have patients move through life in the way that they want to and that they have been able to, but for whatever reason, usually because like thyroid hasn't been addressed properly. They haven't been able to for years. And I think it's also that in our first visit where we, like, I'm getting to know the patient, we're going over labs, and as I explain their labs to them in detail, just breaking it out like level by level and why they're feeling the way that they're feeling, just that relief of there is an answer to this. Like, it's not all in my head. I'm not crazy. I'm not imagining. Like, I can't try harder because I think that's a message that we get a lot of the times is, oh, you just need to do this. Oh, if you did this, it would be better. It's not, this is really not what you're experiencing. And that's, it's hard for women who are juggling careers and motherhood. And a lot of my patients are in their forties. So then we're also juggling like perimenopause and these wild fluctuations in hormones. And knowing that there's a reason for like why they're feeling the way that they're feeling and they feel seen and heard, I think that has to be by far like the best satisfaction I get from doing this.

I totally agree. And I'm curious your thought on this. So my, my percentages, my rates of patients at their new person visit when I explain their labs for the first time, that's 90 to 95% of them say one or one of two things. And I want you to tell me, rough estimate, your percentage of your experience. They tell me exactly what you just said. Number one, so you're telling me I'm not crazy, or you're telling me this isn't all in my head. So 90 to 95% of women tell me that on that first visit where we review their labs. What percentage would it be for you?

I would have to say it's in the high 90s, or it's just not even words, but that relief of tears of like just finally being heard and just the relief of I'm here and I can get the help I need.

Yeah. And that speaks volumes to how badly these women are being gaslit in medicine still. It's just awful. But I'm glad that our mission is to create a safe place for these people where they'll be seen, heard, believed, helped. And so I think that we're living up to That promise. Okay, next question. What is one misconception about thyroid disease that you wish more patients understood?

Ooh, that's a good one. I feel like the most questions I get, and this is geared towards patients who also have Hashimoto's, right, is wanting to get off medication. And I think people who don't have Hashimoto's, I think there is potential for them to get off medication and possibly like still feel good. We're not gonna get optimal thyroid levels though. And I think that's a hard thing for patients to understand. They want the optimal levels. I don't see that without thyroid medication. I think with getting everything dialed in, I think patients can move through life feeling good, but I also have a lot of patients where they're feeling great and they just don't wanna take the chance of not feeling great. So they're gonna stay on it, which is fine. I think for the Hashimoto's patients though, this belief of we can get to the root cause of the Hashimoto's, we can come off of all of our medication. And I just, the way Hashimoto's works, it's itself with we just have less functioning thyroid gland. I just, I don't think that's the possible part. And I think that's hard for patients because I do think there is a big emphasis, which I agree with, of trying to find like root cause and root cause resolution. But I've also, and I'm sure you've seen this as well, I've had patients who've done heavy metal detoxes, mold, Candida, Epstein-Barr reactivation, and they've gone through all these protocols, either tests are normal or they've done the protocols and nothing's really changed. And I think that can be incredibly frustrating as well.

Yeah, I agree. A couple follow-up thoughts to that. Number one is, look, like everyone can't necessarily get to remission because of what— it could literally just be genetics, right, that prime you for Hashimoto's. Research estimates Hashimoto's is genetic in nature 35 to 65% of the time depending on the studies. That alone is hard to curtail, but even reductions in antibodies can be inferred as risk reduction for developing another autoimmune disease. So maybe you're not in remission, but hey, if your antibodies have dropped 50%, not only are you saving more of your thyroid gland from being destroyed you're also probably reducing your risk for other autoimmune diseases, you know, which, which increase when you have one. And then the second thing, that just to wrap that up with a bow, I'm a perfect example. I had Hashimoto's for years and years. I have been in remission for 12+ years now, but I'm still on thyroid meds. Now I'm not actively attacking my thyroid, losing more and more tissue as that attack goes on and takes place, but I've lost— that attack has lost and permanently damaged a large portion of my thyroid gland tissue that has to be offset with medication. And when we take those meds, people get so hung up on not wanting to take meds, and I'm like, look, even mild thyroid dysfunction increases your chance of needing to take diabetes medication, heart disease medication, depression meds, obesity, non-alcoholic fatty liver. So it's like you can take this one med and curtail so many future risks to your health Or you can put a stake in that ground and really want to not do meds, but it ends up causing sequelae and consequences later on. Yes. Last question: outside of medicine, what's something about you that might surprise people? I don't know.

It's a hard one.

It is a hard one.

Let me think. I don't know. Miss Yachty. She's a stand-up comedian on the side. I'm just kidding. Are you still an avid runner?

I— yes, I do really enjoy running. I think my big goal would be— I've done a 30K trail race. I'd like to do another one. I think at some point I would really like to try to do a 50K. That would be something to work towards. I've slowed down on running. It's just been stressful. So very protective of my adrenals cuz I've completely crashed those in the past. But at some point I would like it to get back into that. Other things I enjoy doing though, I enjoy reading, hiking, love spending time with my girls. I have rediscovered my true love of '80s and '90s country.

I love it. We're gonna do a country line dance session for our team at some point, so you'll be primed for this.

No, I will. Billy Ray Cyrus, bring it on. And the most exciting thing, I guess, is I just got tickets to George Strait, so I'm super excited about that.

Oh my gosh, that's gonna be so fun. I love it. That, that's even things that I didn't know about you. So yeah, you absolutely educated us. Yanni, thank you for taking the time to share a little bit about who you are, what you're passionate about, what brought you to MTC. Thank you for all your work that you do with your patients. They so love and appreciate you, and it was fun getting to chat today.

Thanks for having me on.

So, Miss Melody, welcome to the podcast. I am so excited you were willing and open to do this with us.

Me too. I'm excited to be here.

Melody has been with Modern Thyroid Clinic For probably like 8, maybe even 9 years now. 7, 8, I think it was 6 in August, 7 in August, 7 in August. Yeah, that makes sense. Okay, so it's been a while. I had even heard of you long before you joined our team and had so much respect for you in our little micro industry, so We're so grateful to have you here. Your patients love you. Tell us what originally drew you into medicine.

I always wanted to be in medicine, but I wanted to be a neonatologist as a kid, like the little bitty NICU babies. Obviously that shifted with age, and my focus shifted through my own thyroid journey. And when I was 18, I was diagnosed with hypothyroidism and Hashimoto's, but it was a struggle to get there. The symptoms preceded diagnosis by quite a bit of time, and we had to fight for the right labs, my mom and I. And thankfully she helped me because I was a kid, and we finally got them and then got the diagnosis. And then they put me on the, the whole spiel of putting me on the levothyroxine alone, and I felt miserable. So then we had to fight for the change of med, and finally, originally, and eventually got to Armour. And my mom talked to me 2 weeks after starting Armour, and she was like, your voice isn't hoarse for the first time in years. So it was an instant change for me. All these symptoms just melted away and had to learn that the hard way. And it took a little bit of time to get there, probably about a year before I got the dose, got to the right meds for my body. And then because it was such a fight and I saw this basic essential functions and system of life, and I had to fight so hard to get adequate treatment and enough treatment, that it just became a passion of mine, learning it, teaching it, learning to love it. And it just obviously impacted my life so largely that there was no denial how important it would be in anybody else's life as well.

Totally. Especially as like a condition that's almost ubiquitous with women as we age. Mm-hmm. You know, and almost ubiquitously, none of us get access to the care and information. That we so desperately need. Yeah, absolutely. And cool too that the parallel journey for you was like learning to advocate for your health, seeing your mother model that for you, seeing how life-changing it could be, and also probably the resistance that is built into the system that I think many men maybe never even realize happens. And Women are so oblivious until they need the system to support them that they don't know that they might not be met with the information, willingness, open arms.

Yeah. And I didn't know that. I mean, obviously I was a kid, so I hadn't really even been ever exposed to the opportunity to know that. So that was very unclear to me as to why it was such a fight to fix what was going on. I was offered Wellbutrin and all of these other meds as a child. Who exercised every day of their life, super active, and wasn't depressed, but I didn't feel good. And rather than somebody just looking at labs or adjusting meds and of what the root issue was. So it was an interesting journey. I'm grateful for it. Obviously it's brought me where I am and has made me an even stronger advocate for my patients and for my family even. I'm grateful for it, but took some time to get there. Totally.

And it's still a mystery, Melody, why we still operate like this. Like, all of us, I don't know, ask ourselves constantly, like, why are we still doing this? Like, how is this still even happening on such a large scale that people don't even recognize at all that it's happening day in and day out to millions of women?

It's crazy. Blows my mind.

Was there a moment in your training or your career where you realized conventional approach to thyroid care wasn't enough, or did that spark even before your career and you knew going into it because you were a kid as a patient?

Yeah, I think that sparked before because I learned obviously rechecking labs and stuff, being on my own meds. I learned over those years preceding my career where it was like, oh, my labs look like this, but I feel like this. And so it was learning how. Symptoms may not match labs, or labs may not be where they should be for everybody the same. And so if I wasn't fitting the mold, maybe digging deeper as to what else is contributing, or is it a dose thing, or is it the way it's dosed, or is it the medication? So I did learn a lot of that kind of as I was a patient early on, but I still learn it every time I see a patient who doesn't fit that standard or what I expect. And I think that what I've learned over the years the most is to never say this symptom is not due to this for sure. Because obviously we have patients with some of the most wild symptoms that you would not ever think were related to thyroid, at least I wouldn't. And then sure enough, as soon as you fix what's going on, those symptoms completely resolve. And it's just okay. So everybody has their own kind of mold of what their symptoms look like, what their journey looks like. And I just think that That's, it just becomes more and more clear. And it's something that I, the longer I practice, the more I'm at ease with. This is just like, I'm a very black and white person in my life. I like, I like consistency. So when I am very at ease with that, I'm, it's because I've just been, I've seen it all along is not, nobody ever fits the same mold as somebody else. And. It's just, it is what it is. So it's the one area of my life where I'm like, all right, it's not black and white. Or one of the areas, I should say.

One of those symptoms that I think about is like a weird thyroid symptom that one of my patients had when she came in. We fixed her thyroid after one round of treatment, even she— it went away. She wasn't perfect after one round, obviously, but so early on, and it was air hunger. She was like an elite tennis player. But was getting air hunger. It was like, I just can't understand why this would happen. It's messing up my ability to play tennis. And man, it was gone and it never came back.

Yeah, I get that's got to be uncomfortable. I think that one of those symptoms that I learned a while back that just didn't automatically click as something that would be something I would assume would happen was dry eyes for people, because that's just such an impact of daily life. And unless you've had it, I don't think people can understand the strength with which it impacts your day-to-day. And that was one of those things where it was like the first time I saw it and heard it in a patient, I was like, this— I can see logically how this would be a symptom of that. So I think it's probably related, but it's something I hadn't heard about a lot through a lot of patients. And then sure enough, you fix the issue and it was gone. So it's— yeah, there's all sorts of those symptoms where you're just like Never say never.

Never say never. It impacts everything. So who's to say that people can't have these weird, random one-off things?

Yeah, for sure.

Absolutely.

They can.

Definitely. Tell me what you find the most meaningful or fulfilling about working with thyroid patients.

I think giving people their life back, giving them hope, because at least once every few hours there's somebody who's new to this journey who is crying because for the first time they feel there's hope to feel better because for so long they've heard this is the way it is or your levels look okay and there's nothing more we can do for X, Y, and Z. And so I think that is always something that is very heartwarming to hear and encouraging even on my side just to hear that I've given somebody hope. And it just reminds you, because sometimes you don't know, am I making that big of a difference? I know I'm doing my job to the best of my ability, but to know that I'm making a difference in people's lives is— I don't know, it's very nice to hear. And it impacts them and lets them live their life in the best way they can. I think that's probably the biggest side of that, the most meaningful. So it's definitely improving quality of life for patients and giving them hope.

I agree. And I think I've had this discussion with other of our clinicians on this podcast when we chat, and I think patients don't really know that we get so much from them too. Like, it's a bidirectional relationship of like, we pour into them like we're supposed to as clinicians. But seeing them flourish, hearing their stories of how they can show up differently in the world also fuels us and like our desire, like the whole reason we went into medicine in the first place. And I don't think people know that doesn't happen very often in medicine. Most people don't get that feeling back as a clinician.

But we, and we do, I think we have obviously amazing patients and that does fuel us. It reminds us it also, for me, I love knowing my patients. I love knowing intricate details of their lives and their families. And so to hear that also makes me feel like they want me to know those. Like they are— it's a mutual relationship. Like you meet, like you're saying, it's not just me doing, looking at labs and kicking out numbers and stuff. It's getting to know them as a person, which I also really love.

So me too. When we develop this deep and meaningful vulnerable relationship with each other. And it's, it really, it's heart-fueling. I, I can't count on one hand the amount of times a woman has told me, for example, my husband's having an affair. I haven't told anyone. You're the only person I've told. Yeah.

Like, that is how deep patients share, the depth. I agree. And I, and there's no better privilege than to, to know those details and to support my patients and know those little things about their lives or those, hey, I have this mammogram, I'm really nervous about it. And to be able to have that honor to be trusted with that worry and that anxiety and be able to check in on them and just know the little parts of life that make it all worth it, in my opinion.

No, absolutely. And allow us to see them and hold them as a human, right? As a real person, which medicine loses. A lot of the time too, sadly, just it's the way that things are set up is to disconnect from that humanity. But I'm so grateful that our clinicians have found a way to hold on to that and maintain it.

Yeah, for sure. I love that.

Love it, love it. Tell me one misconception about thyroid disease that you wish more people knew and understood.

I wish that more people from patient to provider just really grasped that one size shoe does not fit all. No patient fits into a box, whether that be lab values, symptoms, progression, success, none of it, none of it is going to be the exact same patient to patient. And I think that just allows for flexibility and less rigidity as well. And just, again, humanity, looking at symptoms and saying, okay, your labs look like this, but things still don't feel the way they should. So what can be improved upon and what, what else could be going on if it— if thyroid doesn't seem to be blaring at this point anymore? Or maybe there is wiggle room there. And I think that we lose sight of that in the sense of, as a general whole, medicine puts you with numbers, puts you in a certain box based on symptoms or diagnosis or whatever. And to remind medicine and providers and patients even that Just because you don't fit in that box or those characteristics does not mean that something's different or wrong. It's just nothing in medicine is in a box and is perfectly understood as far as like patient to patient is the exact same. So I think that's something that's lost and we get into the routine of practicing that gets lost and goes by the wayside when there's not the individuality that there should be.

Yeah, I totally agree. And you know what's bizarre, Melody, is I feel like in medicine we don't really ever take a one-size-fits-all approach, but I feel like that's all we have to offer with thyroid. Everyone gets the same lab, everyone gets the same medication. Sure, it's like a different brand versus generic versus other brand, but, and the expectation is, hey, if you don't get better from this, then it's not your thyroid. It's got to be something totally different when in fact it is their thyroid. And hey, we just can't— again, we can't have this one-size-fits-all approach. It's bizarre to me that that's where we're hanging our hat and just presuming that everything is working fine when all of these people are persistently having symptoms. Yeah, yeah. Not functioning outside of medicine. Last question: what's something about you that might surprise surprise people?

This one was hard for me because it's obviously myself, and I— we only find ourselves so interesting. So I would say something that would probably surprise patients is that I am terrible at technology. McCall knows this. I don't respond well to texts. I don't have any idea— my husband set up this light for me. I don't even know how to work it. I am lucky if a Zoom doesn't work.

Way to go, Chase.

There's only so much problem solving I can do. So I think that's funny and interesting that I have no, no ability to do technology. I'm like a 95-year-old. I am a twin. It's probably somewhat interesting, but that's probably it.

Yeah. And you have adorable little babies, one of which is your actual clone. It's just—

Thank you.

That's what I hear. And she's now taller than me, so that's hard to beat. But yeah. She just passed me up.

I'm sorry.

It's okay. I'm not very hard to beat. Like I said, I'm only 5'2". There's not a whole lot of height there. I hope she just keeps going.

I know, and she probably will. I feel like everyone's getting taller. Like, every generation is taller than the last.

And maybe we're just shrinking, but—

or maybe we're— I definitely think I might be shrinking.

Yeah.

Thank you, Melody, for coming on, for chatting, for sharing a little bit about you and your view on thyroid and medicine and life and all the things. We value you so much at Modern Thyroid Clinic. We just, you know, we love and adore you.

I'm so glad to be here with Modern Thyroid and on this podcast.

I love it. Thank you so much.

All right. You're welcome.

Yeah. So I am here with Nikki, one of our incredible clinicians. She's also a VIP Elite clinician, which means she's like the crème de la crème. She's just 10 out of 10. So we are going to sit down and have a chat with her. First question, Nikki, thank you for being here today. Thank you for having me. Absolutely, it's my pleasure. I would love to know what originally drew you into medicine as a nurse practitioner, and then later what kind of created the path for you to end up at Modern Thyroid Clinic?

Yeah, so I think I've always known from a young age that something in medical— I was going to do something. I was always a helper. I always wanted to help people with— I don't know, I would just talk with them through everything. And so I knew that whether it was nursing or some sort of capacity, I wanted to be in healthcare. And so I was probably about 23, and I decided— I was like, all right, I'm gonna go to nursing school. And I did it, and I've been doing it ever since.

I love it. And then what kind of shifted that made you think, I might want to change gears, I might want to evolve out of the conventional model and move towards something like Modern Thyroid Clinic?

Yeah, so I think I knew pretty early on getting into my career. I remember being in my 20s, going to my OB-GYN. She did her exam and she felt my thyroid and she said, your thyroid feels full. And she kind of left it at that, never did anything more. And I just remember I was like, huh, Why say that if we're not going to look further into it? And the more I got into conventional medicine, the more I was like, people aren't getting better in this model. And then I had my own health crisis. And I remember specifically in 2022, I was like, I started questioning everything in my conventional model. And because it wasn't working for me. And that's when I started looking more into like integrative functional medicine. Tried to implement that into my daily practice in conventional medicine, and I kept getting in trouble. Why are you ordering those labs? Why? We don't— insurance isn't going to cover that. And that's when I was like, I've got to do something more.

Yeah, I love it. And was there a moment in your career or training where you realized specifically the conventional approach for thyroid maybe wasn't enough.

Yeah, it was, it was on my own journey too where I remember my TSH was in the 3s and they're like, you're normal, it's totally normal. But I'm like, I have all of the symptoms. Yeah. And every physician I talked to, colleagues, they're like, no, that's just normal, it's just, you're just a mom. And I'm like, there has to be something better. And then I started following you, started following other influencers and doctors and things. And I was like, gosh, there's a better way out there. And started doing these things on myself. And I was like, this— it works. There's something to this. And that in that moment, I was like, I need to be a part of this. This is where I need to be. And it just felt so special.

It is so special.

It is, it really is.

Yeah, yeah.

A couple things that most people don't know about our clinicians and even like our team, everyone has a thyroid issue. I think maybe there's two part-time people that maybe don't have a thyroid issue, but everyone at Modern Thyroid Clinic, with the exception of I think two of our part-timers, have a thyroid issue. So I feel like that's so important because when you've experienced it, you know how devastating it is, how demoralizing it is to be constantly written off and gaslit, how debilitating the symptoms really can be in a world of medicine that's, oh, it's just a thyroid problem, it's no big deal, send them on their way, put them on some levothyroxine. If they still have symptoms, surely it's not their thyroid, it's got to be something else.

Yeah.

And you know what's crazy too is that I had to go through IVF for my son. They checked my TSH, just my TSH, reproductive endocrinologist. It was in the 3s. They didn't say a thing. They're like, we're good. And it ended up taking us 3 rounds. And I, looking back, I wonder, could that have been the delay there? Absolutely. So it's, yeah, it's just interesting looking back in hindsight when you're in that conventional model and that's what you, I didn't know to push further, question more.

Yeah. I think it's like an epidemic, right? That's why so much of what we do on social media and your lives that you have every week and our email list, our podcasts. Like, if people don't know what they don't know, they're never going to get better. And yeah, in a world of like our current thyroid paradigm, you can't just sit back and passively be like, oh yeah, my clinician's got it, I'll be fine, everything's going to work out, right? You'll never get— you'll never get your life back. Like, you have to be informed and empowered consumers of your health.. And if you can't find someone, if you can't become a patient at Modern Thyroid Clinic, we want to give you all the tools and knowledge that we possibly can so that you can navigate this really complex thing and kind of drive your care in the decision, in the direction that it needs to go. Yeah, exactly. Tell me, next question, we're like rapid fire over here. What do you find the most meaningful or fulfilling about working with thyroid patients?

Yeah, so I love this. One of the most fulfilling things— so I talk with a lot of moms and they have young daughters, and so I call it we are creating generational health. Yeah. And so when I'm teaching a lot of moms about this is what's going on with your thyroid, this is our approach, this is how we can get you better, they know better for their daughters, and then their daughters are going to know better, and we're saving them decades worth of those challenges. And we, we know that if they're 18 or early 20s, they're having these symptoms, we know exactly where to go and bypass them all the stress that we did. So that's probably my favorite, and seeing them get better.

Of course. No, I love that, like putting a pin in that because it is so impactful for early screening, early detection, keeping your eyes out for symptoms. Yeah. And I also think like thinking of generational health, I really, I say this a lot, but like the work that we do is generational because when you fix a woman's health, it changes an entire family, their immediate family, generational family, their grandkids. Their marriage single-handedly. It just shifts their entire life's landscape.

Yeah, absolutely. And even for the new moms that they're having babies and their pregnancies are better, I have had moms too that have been on thyroid meds this pregnancy as opposed to like prior pregnancies, and they're like night and day difference. And just all around, all together, yeah, better moms, better partners. We can succeed more in our careers. I see it every day, and it's amazing.

Truly, it's really— it's soul-fueling. Yeah. And it's so cool too. I've had— speaking of like pregnant moms, I've had so many women tell me as they move through pregnancy, postpartum, I feel better pregnant and postpartum with you all than I did before I had children.

Yeah, it's amazing. It really, it really is wild.

Yeah. Okay, tell me, next question: what is one misconception about thyroid disease that you wish more people understood?

Yeah, so that just checking a TSH is enough. We need to dive deeper. We need that full panel. I need to see that full functionality to see what, what's really going on. And another one is that, okay, we have Hashimoto's, there's nothing you can do about it. Let the thyroid tissue get destroyed. Come back to me when you have hypothyroidism and then we'll deal with it. Why not get in front of it and stop the damage from being done to the thyroid and address it early on. So then again, we're not going decades with these Hashimoto's symptoms and when we could prevent that from the beginning.

So tackling it head on.

Amen.

And again, it's what you don't know, you don't know. So we have to make sure people know.

Yeah. And that the treatment for hypothyroid is going to treat the Hashimoto's. And just really educating on the difference between them.

Amen. Yes.

Yeah.

Okay. Outside of medicine, outside of your life at MTC, what is something about you that might surprise people, might surprise your patients, etc.?

I love cruising.

I was wondering if you would say that.

Yes, we are avid cruisers. So I live in Florida, so in the Tampa Bay area. So we have 4 ports near us and they're talking about building a 5th just a little south of me in Sarasota. So I'm super excited. Yeah. So anytime we get a chance to go on vacation, we're like, let's hop on a cruise. Let's go on a 3-nighter over the weekend. So now I have my little son too, but I'm like, what do you want to do this weekend? He's like, we should go on a cruise. And I'm like, you are 7.

You're an expensive date.

Yes, for sure. So that— I don't know if that will surprise anybody living in Florida, but we love the water. Summertime in our heat here, like, you'll find me on a boat, you'll find me at the beach.

So tell me your favorite cruise that you've ever taken.

Where was it? Alaska, by far our favorite. Yep, we did. We flew out, or we flew into Vancouver, did round trip. Vancouver is beautiful, but Alaska, there is just something about waking up and sitting on your balcony with a cup of coffee and watching whales, seeing seals outside. Like, you're always pretty close to the shoreline. And there's bears along the shore. It's just something. It was so amazing.

You all saw bears?

Like grizzlies? Yeah, it was so beautiful. It's— Alaska's so beautiful.

Yeah. And whales are like my magic creature. They're just so incredible.

Yeah, it's like peace just sitting out there. And it's a little chilly, so you're kind of like bundled, but with your coffee just so good. We want to go back next summer.

Oh, I love it. You'll have to keep me posted on if y'all do that and send me so many pictures and video.

Oh, we will. Yeah, they have the train ride you can take too. I don't know if we're there yet. Yeah, so, but I definitely want to do the cruise again.

It'll be good. I love it. That'll be beautiful. Nikki, thank you for coming on and sharing a little piece of yourself and who you are in work, outside of work, your journey. We love you. We so appreciate you at Modern Thyroid Clinic. I hope you know that and feel it for sure. And thanks for sharing a little bit about you with our listeners.

Thank you for having me on and allowing me to, to share a little bit about myself and how much I enjoy it here. And this is truly an amazing opportunity as a provider to help men, women with all of the things and show them the alternatives. And just so grateful to be here.

So thank you.