Normal Labs but Still Miserable - Why Symptom Driven Thyroid Care Changes Everything

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 one 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. Brandy, welcome to the podcast. I'm so excited to have a chat with you.

I'm so happy to be here. I think it's something I've been waiting for for months.

I love it. It has been right. This isn't a long time in the making. So let's dig in. Tell me what originally drew you to medicine.

That is such a fun story. It actually takes me back to third grade. Fiercely. I'm from a very small town in East Texas, and they brought a helicopter, a careflight helicopter into the mall. And I got to tour the helicopter, and in there they gave a nurse hat, you know, the little, they look like little nurse hats. And it had a little medical emblem on the top. And I brought that home and I put it in my room and I said, that's what I'm going to do when I grow up. And obviously that dream evolved over the years, but the medical piece of it stayed forever. And then my mom was a nurse in labor and delivery. So as I was very young, like 12, 13, the hospital had a, like a candy striper role. And so I got to go and do that. I think we were called junior volunteers. It's been a long time. So hard to remember exactly what it was called, but I think it was a junior volunteer. And obviously I hung out with my mom in labor and delivery, and that's where my passion for taking care of women really took off. And so, yeah, I love it.

I had no idea about your mom. That is so, so cool. So here you are. You're in the world of thyroid. I'd love for you to tell us how you ended up here, but your background is also unique, Brandi. Like, I talk about this with so many people who are my patients who are maybe transitioning, and sometimes I specifically send them to you because of your skill set and the history of how you've worked in medicine. So I'd love for you to share a little bit with us about what you spent your career doing that you still kind of dabble in what you do now and how that transition transpired.

I actually would love to. So my husband is super jealous that I literally love my job. I always have so much. I started back in the 90s as a nurse in labor and delivery. Absolutely fought my way into labor and delivery because usually new grad nurses don't get to be in a specialty area. But I couldn't take no for an answer. So labor and delivery, I did that for years. Absolutely loved it. And it was about 10, I think I'm 11 years now. I decided to go back to grad school. So longer than that I decided to go back to grad school and I've been a nurse practitioner for the last almost 11 years. And I worked in an OB GYN clinic. We did Full Scope Hospital OB GYN. I actually have two certifications from Georgetown University. So I'm a women's health nurse practitioner and a certified nurse midwife. And I worked with an amazing physician in a hospital practice where I did everything. I saw so many patients in clinic. I did birth in the morning and birth at lunch and birth in the middle of the afternoon was a very high volume practice. We were busy for all day. And I absolutely loved it. I still love it. I still do it once a month. I take call with him and get to go and hold those little baby bundles and support those moms. So that's been my journey until now.

I kind of just want to come shadow so I can just hold the tiny babies and get a little of the baby snuggle exposure. That's where my heart's at. It's been a long time so I can only imagine how fulfilling feeling that is.

It's so wonderful. I like supporting the moms. I can give the babies back. Let's get a quick picture and then hand them right back to mom.

Hey, that's what we need anyway. So we need people who are invested in supporting the moms. I love it. And then tell us how you ended up in the world of thyroid.

That's also interesting story. So I would have never dreamed if you absolutely backed up and told me about two years ago that I would leave the bedside and I would work in a thyroid clinic. I would have said you're nuts. However, the doctor who I worked with and I absolutely adore was talking about retiring and I had no desire to work for any other physician. So I was kind of shopping for what am I going to do for the next few years of my life? And I ended up at a med spa where I managed the hormone piece of that. And the hormone piece of that included a company that provided an algorithm for us. And in that algorithm, it would tell me to treat people with desiccated thyroid, even though their TSH looked totally normal to me, because, remember, I followed regular guidelines up until this point, so it didn't make sense. And then I would give them this medication and some of them would like it, some of them wouldn't like it at all. There are lots of symptoms, crashing, feeling overstimulated. So there was a lot that went into it. And I kept questioning, like, why are they telling me to do this and why am I doing it just because they're saying it? I need to figure this out. And I went down the Internet rabbit hole and found McCall McPherson. And here I am today. I absolutely find such joy in what I do here, and I feel so passionate about what you have built and that it's right and that it's good and it helps people get their lives back. Now that I can compare what I do here and what I did back then, to me, they're very equal in importance and how fulfilling they are to me and how amazing they are for the patients that I serve.

Yeah, no, it is, it's special. And I've said this with a couple of the other clinicians too. Like, it's unusual in medicine to have the dynamic that we have. It's extremely unusual that you had that also in your last long time position. How special. And I think too, like our culture, people that are similar to us gravitate towards us and vice versa, and it allows us to keep and maintain this. This beautiful culture that we've created and, you know, share with our patients and our patients share with us. It just, it really is special. And we just love having you as a part of that because you just amplify our culture and what we stand for so beautifully.

I love it.

Tell me too, what do you find the most meaningful thing about working with thyroid people?

I love a lot of it, but I think hands down, it's the fast forward. It's when I get you to that place where you. I had one this morning.

It.

I'm going to try really hard not to get emotional, but she comes in and she just is bubbling and she's like, I feel so great. This has been the most amazing year. I got to take care of my kids in the way that I wanted to I showed up for them. I feel great. I look great. I would like to talk about anything else that I haven't come to my appointment because I just felt so good and I didn't need you.

Yeah, that makes me emotional.

Last two weeks ago and I. It's hard to talk about these without getting emotional. But I met her months ago and her TSH was very normal. And we looked at the whole panel and realized that she really didn't have warmup owns and we treated that. And the fast forward of that was she was the same way. She comes into the appointment and she says, I feel great. I don't need anything for you. So now I want to tell you all about my home remodel and my flowers in the backyard. I love gardening. And so let me tell you about all my flowers. And she goes and gets them, like out of her refrigerator and shows me how she's. I don't know what you call it, but germinating like flowers. And that's what we talked about. Like, that's powerful. When you can give women tools and they can just go and thrive, it's

amazing they can go and do things that aren't necessary. That fuels and creates joy and passion in their lives. Because I talk about this so much, like, joy is a hierarchy. It's like the very top of the hierarchy of our needs.

Right?

Like, most of us don't get that we don't feel good enough to be able to participate in life in a way where we have so much energy, we have excess to actually enjoy it. Most people with thyroid issues, even the most mild, are, you know, barely meeting life's requirements and struggling to do so. And the saddest part about that is kind of what you touched on with your first patient is, sadly, thyroid issues hit in our most joyous and memorable and special years. It's around the time that a lot of us choose to have children or want to have children. And thankfully, I mean, I think about this so often when I talk with patients. I didn't have kids when I was in my last absolute thyroid crash. And I don't know how mothers do it, but I do know that they deserve to enjoy raising their kids and have fun with them and make memories and go on vacation and garden if they want to and remodel their house and do all of these extra things that people can't do when they're just surviving. And that really is like the coolest. It's so, so incredible to walk the journey with those people and see that because we see how they come in, they're desperate, they're miserable, we're like the last freaking stop. Like they have nowhere else to go when they come here. And to be able to see that transformation, it fuels us, right?

Yeah.

It changes how we feel.

I know that as a business owner, that had to be hard for you to just step out of the box and create something. But it's thanks to you that I'm able to do that for women. So thank you for creating modern thyroid clinic and for allowing me to be

a part of it.

Yeah, well, we're honored to have you and thank you for that. And it really is. We give so much to these people, but they also give so much back to us and that I think they don't even know how much they fuel our passion and our life's purpose and cause them of what we have at Modern thyroid clinic. Like it's so bi directional, which again, that doesn't happen in medicine. That's not normal, that's not even rare. It's the less than 0.1%. So we are, we're the most fortunate. Tell me one misconception about thyroid disease in general that you wish more people were aware of or understood.

I feel like for me it's about knowing that there's literally no one size fits all. It is so nuanced, it is so individualized and what works for one is not going to work for another. And that there's no way that a primary care who's seeing a full schedule of patients is going to be able to figure out how to make that happen for you. It's just there's such finessing with the medication. There's such knowledge that has to happen to know the different hormones and how, when I change one thing, what that going to impact, how is your patient going to feel, what's that going to look like on the fast forward? And it is complicated and not everyone knows how to do it. And so I think that would be my, my number one misconception is just that there's no one size fits all.

That is the best because it's so true. Like I always say, look, if you're going into your regular clinician's office and they're just checking your labs, checking your tsh, putting you on some level, they are trying to hit a bullseye blindfolded. You know, they're throwing darts at a dartboard blindfolded, hoping to hit a bullseye. The likelihood that that's going to happen is, is negligible. And that's why so many people suffer. And I think it's medicine as a whole. Like, we think that thyroid issues are simply when they meet this lab threshold, you put them on the lowest dose of levothyroxine, and then if they're still not there in six months, you increase them or decrease them. And that will not get people well. This is so much more nuanced than medicine even recognizes. You are spot on.

Well, and not only that, but we'll treat it that way confidently, because that's

the way we work.

Right. And if it doesn't work, it's because it's not your thyroid. It's not because the way I'm treating you, it's not because I'm only offering you one class of medication that maybe would never work in your particular body. It just must be a you problem. It must be eat less, exercise more. Less stress, more sleep, all of these things, which is a travesty, because women internalize that and they believe that that's true. And then there's nothing they can do to get their lives back if they just accept that and move forward.

Yeah.

I think also just accepting seasons of life for what they are. Right. Oh, had a baby. That's why you feel tired. Right. Or you're a college student. I'm sure that you eat terrible food and don't exercise and party all night in your 40s. That's what happens when we get in our 40s, menopausal. It's just the different seasons of life, I think we've labeled them with excuses, and that's the norm. And I've always been one to say no to the norm.

Yeah. And it's just. Honestly, it's another form of gaslighting women and sending them on their merry way to accept the alternate reality that this the reason for their symptoms is something else. And it's not my responsibility as a clinician to fix it, because I have no power over the fact that you're in college or you have kids at home. And they start. What's scary is they start making those excuses really, really young with these people. Like people in their 20s are told, well, you're just getting older. I'm like, no, actually, that shouldn't be the case at all. Like, you should have lots of energy in your 20s.

So true.

Yeah.

We have people in our 80s that have lots of energy, you know, so it's so important. And I think the other nuance to that is women are pushed through people. We have a lot to do that has to be done. And so we just kind of push through and this becomes our new normal. And that can be such an insidious cycle until you wake up one day and you can't really function in life, and you have to rebuild from the ground up. And part of what I love about modern thyroid clinic is it kind of educates and empowers these people to realize early on, later, once they're really good, I want them to know if you deviate 10%, so you can come on back and we can clean it up really fast and send you on your way. And that's really hard to do when you live in that land of symptoms and just muddy water of fatigue and brain fog.

You nailed it.

Tell me, Brandi, I'm so curious about this question. Outside of medicine, what is something that might surprise people?

Well, I have a list of some interesting things. I think the number one is most people. To me, it's not surprising, obviously, but most people are very shocked when they find out how old I am. And I have two grandkids and that I was actually old enough to have grandkids like I was.

Brandy looks 32 in real life. Just saying it.

Somehow it ends up evolving every now and then, like how long I've been doing my medicine career or something. But I am right now 51, and I have two grandsons. And so that's just very surprising to people. I don't know that this is surprising to my. Obviously, the people that know me, but I absolutely love Brantley Gilbert and listen to his music all the time. Time love his music.

Right.

I went to four concerts last year. It's like my fun, most fun thing. A few other things, I think a little dark one. I will say that I am a survivor of domestic violence. Most people don't know that. But in my past life, before my current relationship, that was an issue for me from high school until my early mid-20s. So I feel like every day there's those, like, thoughts of, you're not worthy. You're not good enough. And so I'm constantly having to remind myself that I am a child of God and I'm created in his image and that I am worthy. So for anybody out there dealing with that, you are worthy. On a lighter note, I did a fitness show when I the day before I turned 41. So that was interesting. I am a midwife, a certified nurse midwife, and I think I lost count after a while, but I'm pretty sure I have supported over a thousand women in the birth of their baby and then the years that I've been in labor and delivery, I can't even count for you the number of bedside nursing support that I have done for women. So that's really, really cool. I have one more. My favorite place in the whole wide world is that place where the land makes the sea. That's where I can talk to God for hours. And the last time I was there, I told him I didn't want to leave, and he said, you have to because you have things to do and women to serve. So that is what brings me here every day.

I love that so much. And you are serving them in such a caring, compassionate, educated, supportive, nurturing way. And we are incredibly lucky and fortunate and grateful that your path ended up at Modern Thyroid Clinic. And I still remember the day that I saw your video interview when we were interviewing for a clinician appointment. I immediately texted Haley, our COO and kind of the girl that runs everything at Modern Thyroid Clinic, and I'm like, I want her. She has to come work with us. So I am so grateful that you did. You're stuck with us for life, Brandi. And I know your patients are really grateful for it. And thanks for taking the time to have this conversation with us today.

Thanks for having me, McCall. It's just joy every day.

I love it.

Ms. Jessica, welcome to the podcast.

I'm so excited to be here.

Number one fan.

I love it. In full disclosure, we already recorded this podcast, and McCall didn't hit record, and it was one of my faves, so we're going to try to replicate it. Jessica, tell me what got you into medicine in the first place? How did you end up in medicine in general?

Yeah.

I always knew from forever that I can remember that I was going to be so something in medicine. I was always the little girl. You asked, what are you going to be when you grow up? And I always said, doctor. I just. I knew that I loved taking care of people. So I'm one of five, and I'm the second, but oldest daughter. We're all really close in age. But anyway, I was like the little mommy. Like, even to my sibling that's a year younger than me. To me, it was always such a big age gap because I was always the one taking care of all my siblings. Always friends, siblings, you name it. I was the little mommy. So I knew that I wanted to. I loved helping people. I didn't really understand the role that I wanted. I kind of always said, doctor, I didn't know what a nurse practitioner was. I didn't know what A PA Was really didn't understand what a nurse was, and there was a lot of life stuff that happened that I was like, all right, my goal was to go to medical school. I was like, I need to do something. So I applied to nursing school just to. To really to do something. And I know that sounds ridiculous, but I did, and I ended up loving it. I loved, like, I loved it. I had an awesome education in it. My clinicals were amazing. I was actually in clinicals where I realized that I didn't want to be a doctor. I felt like it was just so robotic just seeing the residents. And I'm not saying that they're doing anything wrong. Just for me personally, I. I wanted more of a relationship with my patients. I felt like it was just very in and out, very in and out. So I went back to. To nurse practitioner school, and I. After working on the floor, and I got my license, and also I got my clinical doctorate. So I wasn't wrong. I am some form of a doctor,

just not an M.D.

hey, I just appreciate that you don't call yourself doctor and confuse everyone. So, yeah. Love that about you.

Actually, at my previous practice, we had to because I worked with another Jessica, and it was confusing everybody. They were like, you just go with Dr. Strauss because you got your doctor. I was like, I hate that. I want people to call me Jess. Like, I like to keep things down to earth. I never want anyone to feel like. I don't know, Jerry, feel when you go into a doctor's office, all of a sudden you just get very almost, like, timid. Right. It's like this, like, perception of, oh, it's the doctor. I hated that. I was like, I just want it to be a conversation. Just call me Jess.

That's what I call you for.

Sure.

Yeah.

Tell me a little bit about how you ended up in thyroid care and when you realized, hey, maybe medicine's approach for how we're looking at thyroid, how we're treating it, might not be the end all, be all. Or maybe it's a little flawed.

Yeah.

So with thyroid specifically, most of it comes from my own experience on how bad I was cared for or not cared for. I'm gonna say, because I wasn't. I started becoming symptomatic somewhere between high school and college. So probably my freshman year of college was when I started noticing symptoms, but for other people wasn't noticeable. You know, it's like something that they can't measure because I've never had a thyroid abnormal tsh. My TSH has Always been very normal. So they're looking at my blood work and they're like, everything is fine. And I'm coming to them with, oh my God, a ponytail, like a horse's mane. And I'm saying, I'm losing my hair.

Yet me.

You have, you have gray hair. What are you talking about? Like, I am losing hair. And no one was believing me until a point that, you know, they looked at me, they're like, oh, you lost hair. So it was hair loss and weight gain and brain fog, and I was feeling exhausted and they were like, oh, well, you had mono when you were 18, so it kind of makes sense. Maybe you're still tired from it. So it was lack of care for me and so many years of being told I was crazy, right? Or like trying to pinpoint it to a point in my life that always, oh, you're. You were in college, so you're probably not eating the same diet. Oh, well, you're back in school and you're working. Oh, well, now you're back in school, you're working, and you're. You're a mom. Even though my symptoms never changed, it was so easy for them to point it and say, I'm not doing enough. So that started getting me thinking. And actually when we first recorded this, I didn't tell you, but in school when I was getting my doctorate, my professor that was going over a thyroid everything with us, I don't want to say endocrine because I feel like thyroid is separate in my brain. So the thyroid lecture, she said, guys, this is how I have to teach it to you, and this is how you're going to answer the questions. But I'm also going to teach it to you another way that I want you to practice in real life. It's not a hundred percent the same, obviously of what we do here, but it was a lot. It was T3 and Hashimoto's does not equal hypothyroidism type of stuff. So it was enough to get me thinking one about my own health. Like, hey, maybe there is actually something going on. So that kind of. That like put a layer of thought and then actually practicing as a pcp, I had so many women coming in, sounded like me, just like me. And they're saying that they feel like something is wrong, but everyone is telling them that everything is fine. And I had a lot of patients that actually, because I followed you for so long, where standard for me. And I was also really lucky at my previous practice I had. And when I say wiggle room from standard insurance protocol. So the doctor that I was working for agreed that it was wrong, that just tracking a TSH was wrong. So I was very lucky where I had that freedom to do as much of what I knew as a full panel as I could. I had so many patients that ended up having Hashimoto's that did not know that, went to go see endocrinologist and told me. I never had these checked, even from an endocrinologist. And you're the first person that found this. So it was women coming in that also had these issues. And I think the icing on the cake for me was I had this one patient I will never forget. I had historical data. I had antibodies on them, and their antibodies were still high. They were in the hundreds, but all of a sudden they did not feel well and really did not feel well. So I did blood work and I repeated their antibodies, and they had shot up to over 10,000. And I called up the endocrinologist that day and I asked them, can you see this patient? And their response to me was, why they have Hashimoto's. It's always going to be there. There's nothing different I'm going to do for this patient. And that's when I realized there's something really wrong. I'm not crazy. My patients are crazy. Medicine is failing them.

Yeah. Amen. And I love so much and appreciate deeply that you had these professors, physicians, along your path to kind of plant those seeds. Because it takes a lot to question a paradigm that we're taught and held to. And a lot of times it takes, like, personal experience. And that's the thing I think so many people don't realize about the clinicians at MTC is all. Every single one I can think of has a thyroid problem. You know, we've all experienced this. Like, most of our clinicians are here because they were passionate about this before they even came here. Like you, you know, you were trying to implement what you learned from. From us before you ever even worked here, you know, and. And that's so admirable. And I think it's so valuable for people to know that because they can feel confident when they come here. You'll be heard, you'll be seen, you'll be believed, you'll be helped. And after you've been gaslit and kind of turned away so many times, that's incredibly powerful.

Yeah. And I know just statistically, we also spoke about this list, so I think it's so important to share again that how women are so gaslit in medicine. And it's not even anecdotally like we have research to show how women's care differs from men's care. Right. And you had brought up that statistic of women being diagnosed at later stages with cancer than men. And unfortunately, something that I'm going to put myself to the side, obviously I was also gas lit, but something that I live through that also makes my tone for patients. And I don't think I actually ever had a bad tone. But if a patient is saying that they're not feeling well, they're not feeling well. People just don't make things up.

Right.

So I guess another level of appreciation was two patients in my. My family or two people. Sorry, my. In my family died because of obesity bias. And my grandma and one of my cousins and my project, my doctorate project was on obesity bias in healthcare as a passion project for my grandma who had passed away and was diagnosed at very, very late stages with a rare form of spinal cancer. She was complaining that she couldn't feel her feet for years. And they kept telling her it was because she was overweight. She ended up in a wheelchair because she couldn't walk anymore. And they were like, it's just because you're overweight, you need to lose weight. She ends up having a very rare form of spinal cancer that like ate away at her spinal cord. She was having heart issues. They. She ended up having sepsis in one of her heart valves that they had to do a transfer. Did not do physical therapy with her in the hospital because she kept saying that she doesn't feel well enough to do it. And they were like, okay, well, she doesn't want to do it. So they kept throwing. But I mean, it was a cascade of so much. And it was one problem after the other after the other, and she ended up passing away. And that level too, if you think about thyroid patients, right, we're coming in. I'm gaining weight. Well, you need to diet and exercise more. But I'm doing that. But you're not doing enough. So you put being a woman and having weight problems on top of that. No one listens. And what's so special here at Monothyroid is no one will ever tell you that that's in your head.

Ever.

Absolutely no. A hundred percent. I had no idea about that, about your grandmother. Do you know the form of cancer, if it was found earlier, is it a treatable form? In many cases.

So I don't know the type. But they. One of the. So she had the doctor that diagnosed her was. That was like our. I don't even remember how it got there, but it was a very good. It was actually a very, very, very good doctor that diagnosed her that did say that if you had found this, like, I wish you would have found this sooner if someone had listened to her. So she didn't actually die from the cancer, but she did become paralyzed from it. So she wouldn't have ends up being paralyzed from it, Right?

Yeah. That is just devastating. And, I mean, I've experienced gaslighting, too. It's like they'll pin anything that's easy and convenient as a way to. To blame the patient. And I just want to put a pin in what you said in the beginning, which is look like and echo it. Women are busy. We have a lot going on. Most of us have careers. We have families. We're managing everyone else's health. The last thing women want to do is take time to go to their doctor to ask for help. Like, I can tell you right now, if I show up at the doctor's office, it's because things are really bad. And I think it's the same for the vast majority of women. We don't want to occupy our time over and over, going and asking for help. Like, we want to solve the problem and move on because we got a lot of stuff to do. And so I think it's frustrating that medicine thinks we have nothing better to do and thinks that when we tell them that we're eating well and exercising, that they don't believe us. So, anyway, it's. It's a long rant, and it's frustrating, but it is a pervasive issue we see all day, every day in our practice. And it's frustrating. It's so frustrating.

It's so frustrating. And with diet and exercise, we know that diet and exercise is not the only thing that contributes to weight issues.

Right.

Or if my favorite is when people come in and they're, you know, they're starting to say that they're. They feel like their mood is lower than where it was, or they're starting to feel more anxious, and their first suggestion is, you need to get on an antidepressant, antianxiety medication. Something else could be wrong. It doesn't even have to be. Let's say it's not even thyroid. There's a lot of times it is. But even something is looking at vitamin D, right? Like, there's just. There's so many things that we can look at, whether it's micronutrients whether it's thyroid. How come insulin isn't just standard of care to check? You can go years of having insulin resistance before your A1C starts to change. There's so many issues. And for women, like, you're saying, we're so busy that to just take time to take care of ourselves, only to hear you just need to go on an antidepressant and diet and exercise more. It's so discouraging.

It is. It's so discouraging. And it starts so early. I mean, those symptoms in thyroid women start in their teens, 20s, 30s, and that's a lifetime ahead of them that they are masking and trying to band aid whatever's going on underneath. Right. And it's the same with hormones. Anxiety from low progesterone. Like, pretty much every woman is going to get that at some point in time. And most of them will be offered an antidepressant when the large portion of their anxiety can be fixed in 48 hours with progesterone. So. Yeah. Tell me, Jessica, what do you find most fulfilling or meaningful about working with thyroid patients?

It makes a difference. I am such an empath, and sometimes it's, like, embarrassing because I have crying so many appointments with my patients when they're like, I'm just feeling so much better because I, I, I feel it because I've been there, and I feel my patients feeling better and how many years we could have felt better. Yeah, the best years of our life. We're just trying to figure out why we're not feeling good and how many things, even if we were there, but, like, not fully there, how much we missed.

Right.

Being there for our family, our friends, our kids, ourselves, and to. Actually, one of my favorite things that I do with my patients is when their thyroid blood work is showing that they're in new thyroid and their symptoms are obviously matching that, meaning they feel good. I asked them, from when we first met till now, how do you feel? And that's usually where it gets them. And then we just start crying in my appointments, and I pretend I'm throwing confetti at them because they want to celebrate that moment. It's. People's lives are changed. People's lives, not just their lives. I know you always say this, that people that are involved in that person, so whether it's a husband, a child, that their lives are somehow, you know, connected to that individual, their lives are now changed. And actually, I think one of the craziest things for me is when I have patients that are related to each Other. Right. And so I had a few patients that are, whether it's mother, daughter, sisters, and whatnot, where they feel hope because their family member is feeling so good. And even that moment, they may be coming to me as a new patient, but they have hope. It's just giving people their lives back. Or the thought, like, I don't have to feel this way forever. To me, I can do that all day and every day. And I think you would agree being healthcare provider as a mom is really hard because our day, we're taking care of our kids, we're taking care of our significant others because we're also kind of their mom. And then we have to take care of other people.

Right?

Have to take care of other people. And sometimes it's really draining. It's like, I'm not putting enough into myself sometimes. But I would never change it because of all the moments of, you changed my life. Like this changed my life to me. That fuels me. It fuels me. I love it.

No, it really does. And not many clinicians get to experience that. Like, in medicine, that's not most people's experience. Most people don't have really positive relationships with their patients. They. Medicine's difficult. Like, it's hard. It's kind of grueling. And working in an insurance model, it's really hard to tangibly hold on to that passion because you're so overworked. Appointments are so condensed. And so I'm so grateful. I'm incredibly grateful that we get to do this work. And I think it's one of the reasons, you know, when people ask, look like, well, why don't you take insurance? It's like, cause we can't. We do the same thing everyone else does that you're frustrated by. We can't solve big, complex issues and educate and empower you in eight to 12 minutes. Like, that's just not possible. Tell me a misconception about thyroid that you wish more patients or more people understood.

Yeah.

It's not a life sentence, guys. At the end of the day with thyroid, whether it's hypothyroidism, whether it's Hashimoto's hyper graves, with your thyroid, if you are being managed appropriately, you can feel just as good now than you did at your best. And I. I know we spoke about this the last time, but I think it's kind of hard to. For people to understand that. But when we're giving you. If you need thyroid medication, we're giving you back something that your body is not producing. It's not like, we're giving you something to do something, then to do something else. It's giving it back to you at the level that your body needs. So it's not a life sentence. Like, we can get you back there. Getting you in EU thyroidism is absolutely possible. Getting you in remission of your autoimmune disease is possible. And it doesn't need to be this. Well, that's just what it is, right? Like, this is just life. It's. I'm gonna get to where I just where I think I deserve to feel. And we can do that.

I love that so much. And that's why, like, our little slogan and hashtag is, there's no reason to still have thyroid symptoms, because it is. It's this misconception of, well, you have hypothyroidism. So this is what the rest of your life is going to look like. You're going to struggle to get through every day. You'll struggle to find joy, all the things. But it doesn't have to be that way. And that's something that I hope more and more people are able to know. And I hope it's a message that we can spread louder and louder, even for people that never become our patients. Because I want people to know. I know you want people to know that there's a better way, that there is hope and healing is really possible.

I love that we do the lives to help those patients, too. So I don't know if people know this, but if you're listening thing, three of the clinicians, we go live every week. So whether. I mean, obviously we cannot filter out who's watching it. So it's not exclusive to our patients. The reason why we do this is because whether you're a patient here or not, we want you to understand that, like, you have the right to feel like you're living your life, like, actually living it and not just going through the motions of the day. So here's what you need to do for that.

Right?

And that's why we do those lives.

Absolutely. Tell me, outside of medicine, outside of life at modern thyroid Clinic, what's something about you that might surprise people?

Everybody in this office is going to expect me to say that I love

Disney, which I do. I'm obsessed with Disney.

And I go, I know Disney, like, in my sleep. I can do the whole thing. Disney to me, is my happy place. But I'll give you another one, because some of my patients know that already. I love to travel. I know a lot of people like to travel, but I like to travel because I love to experience different cultures and I love change. Actually, when I got this job, I looked at my husband, I was like, you want to move? Because it's something that we were talking about for a while and I was working in an office and he's been working remote for years. And he was like, okay, let's do it. And we sold our house in seven days, moved down to where we live, knew nothing about it, because I was like, you might as well just try it. I love trying new things and I love traveling. And traveling, oh my God, it really fuels my, my soul. It's like other than my family, of course, I just, I need to travel. I love traveling with my kids. To me, is, is the best, hands down, with its challenges and with its reward. Like, I'll take any of the challenges because I'm either doing it at home or I'm doing it on an airplane or hotel. Like, to me it doesn't matter. And actually, one tip for any parents that are listening, if you have the opportunity to travel with your kids young, do it. The younger that you start, the easier it gets because then they, they understand it. And my kids now, they're like, I think that they're professional travelers. Like they get on the airplane, they set themselves up. I let them use their iPad on the airplane, but like, they don't. They barely even use it. They'll watch like a movie, but. But they play with their toys. They do their own thing. It is, yeah, it's awesome. And I think it's because we started so young and doing these long flights.

I love it.

I love traveling. I want to world school my kids. That's my goal. I sound like a lunatic saying that, but I want them to experience it. And I think I've been this way for as long as I can remember. I've loved to travel. I got medicine. Sound ridiculous, but in middle school, I was nominated as a student ambassador. I didn't tell you this, so I was nominated as a student ambassador to represent the US And I traveled to Australia, New Zealand with just other kids and like this professional government run organization without my parents. And I was there the entire summer. And I always loved to travel before that. But that trip, I think that's what made me love experiencing different cultures. I got to stay at a homestay with a family from New Zealand. I'll never forget that. And to experience their life and what it was like. I get the goosebumps thinking about it. That was like my first, I think, real intro and so what? That was like. I loved it.

I can absolutely see you as, like, our national ambassador. You would do so good at that.

Like, I would love that. Can we make

that tracks? I tell you, what a cool experience. And I know I want to world school my kids, too. I keep trying to talk my oldest daughter into it. I'm like. But really, like, what if she's like, complaints about school? I'm like, well, what if we just moved to Italy and we world school you there? I haven't succeeded yet, but if I do, I'll let you know. And maybe we can coordinate.

We will coordinate. Because, you know, I love Italy.

I know you do. Well, Jessica, thank you so much for taking the time out of your busy day to share a little bit about yourself with our people. And thank you for your work, your dedication to our patients, to people struggling with thyroid dysfunction at large, and you just mean so much to us.

I love it here. I do. I always say it. I said, on every one of my lives, Modern Thyroid changed my life as a patient and also as a provider.

I love that. Well, we're so grateful to have you.

Thank you. I'm grateful to be here.

Crystal, welcome to Modern Thyroid and Wellness Podcast.

Yeah, I'm so excited. A little nervous, but so excited.

You're gonna do great. This is just a chance for people to get to know the incredible, amazing person that you are. So I'm so excited to share it with everyone. So thanks for getting a little vulnerable with us.

I know. Definitely new things new year.

Right?

You're not uncomfortable, and you're not doing things right.

I know. That's what I tell my kids. Look like, you got to be uncomfortable, and then, you know, you're challenging yourself. So you're doing a great job.

I'm here.

I still remember my first podcast interview, and it was with the biggest health and wellness podcast at the time. It was with Wellness Mama, and. Oh, yeah. Yes. I was so nervous. Like, I had my, like, notes, and. But it, you know, it was. I was like, wow, this was actually kind of fun. I kind of like this. So that's how you'll feel after this too.

Okay, good. Thanks.

Tell me, Crystal, what originally drew you into medicine?

Honestly, So I think we've talked about this before, but I'm like, the classic type a overachiever oldest daughter, you know, and thought I was gonna go into medical school. I actually went to College and at 15 years old, graduated a little bit early from high school at 16, and then was just like, I'm gonna do Medical school, and things worked out a little bit differently. I got my first degree in health promotion, which has kind of, like, laid the foundation for what I do now. This integrative, functional wellness aspect that's always kind of in the beginning of this preventative medicine type of thing. And I think it's just been kind of a journey. And luckily I went to nursing school and to NP school, and that has been really great and really fun. And my first, actually, when I was a nurse in the hospital, my. My first job was with transplant patients, with, like, liver and kidney transplant patients. And I realized at that point that it was kind of too late to do anything right for them. Meaning, like, preventatively, like, they're there getting a transplant because of maybe alcohol, you know, being an alcoholic, maybe from diabetes and, you know, needing kidney transplants. And so really, I knew, like, going into NP school that I was not going to follow the traditional route of, like, being in a hospitalist or working in primary care, that preventative medicine was going to be more of what. What resonated with me, especially given kind of, like, my foundation in exercise and wellness initially. So pretty much my whole MP career has just been, like, focusing on integrative medicine, which has been amazing. And I've loved it so much.

I love that. And it is. It's a unique kind of type of person that looks at the body and looks at medicine in that way. And I feel like it's so, so incredibly valuable for you, but also obviously for your patients. Tell me how you ended up in thyroid care, or was there a time, a moment, an experience that made you kind of say, maybe the conventional approach, the traditional approach isn't quite enough for these people.

I think. Honestly, I think that's what brought me to modern thyroid. Was my best friend. She from high school. Like, we've known each other forever. She ended up in the hospital with a thyroid storm, ended up with grave disease, found you all, and then was like, oh, my gosh, you've got to watch these TikToks and podcasts. And, you know, she was asking me questions, like, about her thyroid. And I was hard because I couldn't. I don't feel like I could give her the information that she needed from a conventional standpoint. And so that's kind of what drew me to modern thyroid and listening to you and listening to, you know, all of the other kind of thyroid experts and realizing that there was a different way of doing things. And I think what I enjoy practicing outside the box a little bit because not always what is traditionally done standardly done, doesn't mean it's the right way to do it or that it actually works. And so that's where, you know, thyroid has been very interesting. And honestly, my first love is, like, hormones. I love, love hormones. I love menopause. I love perimenopause. And so it's just this, like, perfect combination of hormones and thyroid, and symptoms overlap so much, and we get so many women that are, like, their mid-30s, 40s, that's midlife. And they are just struggling, right? They're struggling to just make it alive. And I think what's interesting is, like, I've always done the hormone aspect, but I didn't consider the thyroid as much because unless they were diagnosed with, you know, low thyroid, hypothyroid, or Hashimoto's, you didn't really do much. And so I think that's where now I'm not just looking at hormones, I'm looking at thyroid. And not, like, it's such a good marriage of, like, how patients can really feel so much better.

That's so true. I was just thinking the same exact thought of, like, how cool that you got to start in the world of hormones. That is. It's so incredibly impactful. But you probably unknowingly had this missing piece. But when you put it all together, they synergistically work together. They amplify the improvement that these women are feeling, and you sort of get this complete picture of how to really profoundly change these women's lives. Right. It's.

Oh, my gosh. Yeah. Well, and I think thyroid patients, they're so used to functioning at this, like, low level of just barely getting by with life. And then once perimenopause hits, I think that's when it becomes even more apparent that there's something wrong going on and that it's not just hormones and it's not just thyroid, but you really have to kind of address both of them together. So that's what I think we do really good at. And I find it interesting, too, because there's not a lot of places that just do hormones and thyroid. Like, women come to us, they're like, I'm seeing this provider, I'm seeing this provider and this one. And really, when we're able to kind of do both of them together, we're really addressing more of what's going on.

Totally. And we get the question all the time, like, well, do you guys treat hormones, or do I have to go somewhere else for that? And we absolutely treat hormones. And honestly, like, I mean, I don't want to say 100%, but I would say 99.9% of our patients also have hormonal struggles that can be addressed and really be another whole layer of. Of improvement. So we do that. That is our shtick. And it's so great that you came here already so passionate about it.

Yeah, no, I do. I love it. And you, like you said, like, thyroid has been that missing piece that I didn't know I needed, but really has just changed life for people.

Yeah. Tell me what you find most meaningful about working with people that struggle with thyroid or hormonal issues or both. Obviously, this is.

So. I was thinking about this the other day. I had a. A lady in her 80s, and she felt awful. She's just on, like, a T4 medication. And, you know, we. We did some things. I was the first one to tell her she had Hashimoto's. Like, she's been on thyroid medication for 50 years. I was the first one to tell her she had Hashimoto's. And she's like, what? What's Hashimoto's? What's an autoimmune disease? We, like, went through all of that, and we started, you know, talking about diet. She's like, well, how does that relate? And so, you know, we started cutting out gluten. Her husband is not very happy about it, though. She sent me multiple emails because her husband is the one that does the cooking. And so he's like, why do you have to be off of this? Why can't you eat gluten? And then I show her in the labs how much her antibodies have decreased and how much better she's feeling just by switching these things up. But I can imagine, like, being 80 and not knowing that you have an autoimmune disease. But it's happened a couple times where I've seen that.

Yeah, no, absolutely. It's like medicine looks at Hashimoto's as this arbitrary number. It doesn't really mean anything. You don't need to worry about it. Hey, we'll just treat your hypothyroidism. And it's just another way that women are getting disempowered, like, when you don't know, you can't do anything about it. And so much of the message from. For us or from us to people who are our patients but also are not, is, hey, you have to be informed and empowered because you will not get to where you need to be unless you are. You can't just rely on whoever you go to See, to manage all of this and outline it for you in a way that's going to actually lead to success and vitality. And I hope we continue, you know, to spread that message and more and more people hear it because it's so important in this specific case especially.

Yeah, well, and I think it's interesting because. So go to Endo. It's checked once. Maybe, maybe it's checked once. But the idea is they're going to be on thyroid medication anyway, so why do we need to keep checking it? But I mean, if you're not checking the data like we're checking every three months, we're checking antibodies every time, and we can see the trend. We can see what we're doing is actually making a difference. Because, I mean, if you're checking it once a year or not checking at all, you don't know. And so of course, Endo is going to be like, well, regulating your antibodies isn't going to do anything for you. But obviously we see that it does because we watch it and we talk to patients and it does, it does do things. It does work. And that's what I think is amazing, is that what we're doing is actually working and patients are feeling so much better.

I know, it's the most rewarding. We really are lucky. We're so, so incredibly fortunate to be able to serve these people in a way, you know, one where many people would never get help. They'd never get their lives back. They'd be stuck in this cycle of up and down with levothyroxine or oh, no, it's not your thyroid. It's lose weight, eat less, exercise more. And it's so passion fueling to be able to step in and be like, yeah, no, let's look at this a different way. Let's. There is something we can do about it. We can make an impact in how you feel.

Yeah, for sure.

Absolutely. Well, tell me to what's a misconception or something that's misunderstood or a through line that you want people who are listening out there to know or that you wish more of them understood about the world of thyroid?

Well, and I think it kind of goes back to, you know, what we were just talking about, you know, checking antibodies, that's something that's misunderstood, that, you know, a lot of patients don't recognize, that when you do it, it can make a difference. Giving T3 medication can, you know, completely change the way that they feel. Diet, certain lifestyle, diet, supplements can make a difference too. I mean, it's not Going to completely fix the problem. But it can make such an impact on how people feel, I don't think, especially Hashi patients and even thyroid patients, how many food sensitivities they have. And you know, just by cutting out one thing can really change the way that they feel. So I think there's so much more to it than just here's a thyroid medication, which it is a part. We do the medication. Right. Like we believe in that, but we're also now including a lot of the lifestyle portions into it, which I think is what a lot of people are missing. Yeah.

And it's like, look like we get a head start, we get people improvement really quickly in a short period of time by harnessing the power of medications and filling in the gaps of their hormones where maybe they don't have enough T3 or they have too much reverse T3, your inhibitory hormone. But that won't take them the whole way. Right. Like we still do. We need to address lifestyle, we need to address gut inflammation, we need to address hormones, adrenals, metabolic issues. Like it's all of those additional things that get people to their highest level of self, you know, and not just the bare minimum that you can get from a medication, which is actually a lot. Like you can get a lot from thyroid medication, but usually there's other systems that are impact impacted, you know, and addressing all of those. Just when we think about energy, on a scale of 1 to 10, we always want our patients like 8, 8.5 in the end. Right. And thyroid medication might get you to a 6.5 or a 7, but when you layer in all these other things, it can get you to an 8 and 9 and that is incredibly powerful.

Yeah, I completely agree. I mean, it's just been so fun to watch. I mean, just, just this week I have a patient who very athletic young girl. Her TSH was almost 100. You know, her T3 and T4 were like super, super low. And she didn't want to do any medications or really anything. And I was like, let's just, let's just try this. Let's just see how you do, how you feel. And I mean, one appointment, her labs are now perfect. Like TSHT3, T4, one appointment, I was like, this is pretty incredible that after just one. And that doesn't happen all the time, obviously it's a process. It takes multiple appointments. But just after one, I was just stocked, floored that her. She went from a TSH of 100 to now less than 1. And her labs look beautiful. And I'm just like, I can't wait to talk to her this week because I'm just so excited after seeing her labs.

You'll have to let me know how it goes and like what she says. But I think this is such a conversation to highlight because I think people see us and they know that we address things in a holistic way and they know that we take a different approach. But then I think sometimes they can confuse that with, oh, well, they'll help me without medication. I don't need medication. And for the vast majority of people who come to see us, they've actually lost endogenous thyroid gland tissue that functions. So they don't make as many hormones. And we have to offset that, right, by supplying them with these missing hormones. And people who are natural can be kind of resistant to that. But I always tell them, look, like this is what your body is naturally missing. Like we're giving you what you're missing. And these little medications right here, one will absolutely change the way you feel on a day to day basis. But two, they'll protect you from actually taking medications that are simply band aiding an issue. You know, high cholesterol, diabetes, heart, you know, all of these things. Whereas if we're influencing your thyroid, it's the root cause of all of those other conditions in so many cases. And so fixing that actually mitigates you having to take a bunch of unnecessary medications later or that might actually come with negative consequences. Whereas thyroid medication, when done well, can help prevent infertility, heart disease, fatty liver, obesity, depression, all of these sequelae that happen even when thyroid issues are mild, even when medicine says they're too mild to treat, or they're subclinical. All of those things change the trajectory of someone's long term health span, lifespan.

So and really it's quality of life too. It's tell, you know, people they're feeling miserable and this can be a really big, huge thing for their quality of life. And kind of going back off what you're saying with subclinical hypothyroidism, like you can be super symptomatic and your thyroid function doesn't look that bad. And we're one of the only places where people will come in and we're like, okay, we're going to treat your symptoms, we're also going to be watching your labs. But I mean, just I keep going back, but I had just the lady the other day where she's like, thank you so much. Like, no one has listened to me. No one has given me any thyroid medication that I needed. She's like, my whole life is different and so many things have been improved upon and she's trying to get pregnant and all these things. So I think it's really impactful sometimes what a little bit of medication can do. And I think about it the same way that I do with prescribing estrogen, progesterone, testosterone. Those levels are dropping. And it's not that giving it back is going to improve that function. It's now you're giving back what's missing. And that's kind of the same thing with thyroid, is that those levels are decreasing. Your thyroid's not producing what it needs to. So we're just helping to support that. It's not that we're trying to, you know, supersede it or suppress it or, you know, give you something that you don't need. It's just supporting what your body is asking for.

I totally agree. And it's so interesting you bring that up. Like, you know, a lot of hypothyroidism is due to Hashimoto's, but I actually see a lot too, just due to slow decrease in function over time. And it's like every other organ system in our body. As we age, it works less and less efficiently the same way that we kind of have ovarian decline. I see the same with thyroid, even in the absence of Hashimoto's. And keeping up with that deficiency can change the way people feel. And like, the other thing that I view it, and this is kind of how we have things set up at modern thyroid clinic, is it gives people an enormous platform to make lifestyle changes because they feel better. So even people who want to do it naturally and improve their lifestyle, this allows you to feel good enough to take on all of that and really make it happen, you know, Whereas if you're just struggling to get out of bed every day, it's really hard to eat. Well, exercise three to five times a week and do all the things you need to do. Because the simple, the basics are a struggle.

Yeah.

I mean, no one wants to work out when they want to go take a nap. Like, I mean, most of our people, right, Three o' clock hits and they're ready for a nap. Like, you can't go work out after that. I mean, you're just trying to survive and get out of bed and do the things. So, yes, it just adds in that. And I always tell people, like, thyroid medication, it's not like a stimulus. It's not something that's going to make you lose weight or all of a sudden you're this whole different person. What it's doing is helping you to feel like a normal person, to be able to get back to what other normal people do. If other normal people can go till 8 o' clock and then go to bed and not have to take a nap in the afternoon. Right. We have achieved what we are looking for. If they're able to lose weight with diet and exercise, then great. That's what we're trying to do. Because as you know, like with thyroid patients, they can do everything. Everything. I always am like, you guys are the healthiest people I know, right? You diet, you exercise three times a day, you count every calorie, you take every supplement, and they have the hardest time losing weight or being able to just function. So I'm like, my goal is to get you to where you feel normal. That's really what I'm looking for.

Absolutely, absolutely. And so many people are walking around outside of that.

Yeah, yeah.

So Crystal is one of the most fascinating people that I've met in years. I got to spend a lot of time with her when we did the National Menopause show and we all stayed in a little Airbnb and we went to Disney and we stayed up late chatting and it was just so delightful to get to know you on a deep level. And obviously I know you're not going to share everything you've shared with us here, but I'm still so curious what you do share. Tell me, outside of medicine, what is something about you that might surprise people?

Well, I mean, as, as you know, my husband did the whole dolphin trainer thing. He was in the military, he was a dolphin trainer. On the weekends we would go and like, feed the dolphins. So that was always a really cool experience. We lived in Hawaii for, you know, four plus years, which was amazing. I, I plan to go back and live there forever because it's amazing, the beach and the ocean and I come from a very large oldest of eight kids. And you know, my family, my grandpa was a polygamist. So that's always exciting. Lots of cousins and so. And that's also been really fun too, because as I have talked more on social media, on Instagram and Tick Tock, I've had so many people, so many of my cousins in my family who I don't see very often, comment, and just this morning, my cousin, one of my cousins who I haven't seen in like 10 plus years, messaged me and she's like, my TSH is 300. Should I start medication? Like, I don't really want to start medication. And I'm like, girl, you can start medication. So anyway, that has been a blessing too, because I have such a large family. I'm able to make an impact in their lives just by sharing, you know, what I'm passionate about. So it's been a lot of fun. And, you know, I think it's been really helpful too, getting to be the family clinician. I think, as you get to be too. Everyone wants questions on what to do.

Pros and cons with that, Crystal. Pros and cons.

Oh, my gosh. Yes. I know.

It's funny.

I feel like it never gets to shut off. Like, the weekends, the holidays, there's always someone texting you about something. Sometimes you want to be able to, like, not think about medicine for a little while. But I think that's just a part of who we are. And that's what I think brought most health care workers into the health care space, because that's just who they are and ingrained in their personality and what they do and what they love, even if it tends to be a little much sometimes.

Yeah. Okay. You have to go back and tell us more about the dolphin training. What was he training dolphins to do? As much as you can share. It's just fascinating.

So he was a dolphin trainer, and they don't do the program anymore, so he was the last one to do it. But the dolphins go and they search for mines under the water, so the explosives that aren't exploded, essentially. And so they have these pools and they, you know, take the dolphins to all different places. Like, he went to Hawaii one year where he took the dolphin in the pool and did all of their exercises and stuff. But it was really fun getting to go on the weekends and getting to see them and to kind of. Every time we go to SeaWorld now, like, we can't. It's not the same. It's so different. We're like, wait, we're supposed to be there? And then we'll be talking to my husband, being like, so, like, what are they doing now? Like, you know, is this a secret? Like, what are they doing now? You know, with all their hand signals? And so it's been really fun to kind of see that. And I wish he could still do that now. His job's a lot more boring. But that was his first, too. That was his first experience in the military, was getting to be a dolphin trainer. So it's kind of all downhill from there.

Yeah, it's gotta be downhill from there. It definitely does, but that is so cool. And we could have a whole podcast episode dedicated to the fascinating life of Crystal. I promise you. Truly, truly just the coolest human. So thank you so much for coming on today, for sharing a little bit about yourself, about your view of medicine, and just who you are with us, with our people. And we just appreciate and value you so darn much.

Thank you so much. It's been super fun. A little scary, but definitely fun.

Until next time.