Still Struggling with Thyroid Symptoms?

I'm so excited about today's episode. We are talking with someone I have been wanting to meet with and discuss all things thyroid with it is Ina Topolaer who is a board certified clinical Nutritionist with over 20 years of experience in clinical practice. She's the founder of Complete Nutrition and Wellness, an integrative practice, the creator of Thyro Love, the supplement specifically formulated for those with Hashimoto's. She's also the host of Thyroid Mystery Solved, Hashimoto's and Hypothyroidism Revealed podcast and the educator behind several highly sought after programs, Thyroid Mystery Solved, Hashimoto's roadmap, the 10 day Hashimoto's weight Loss Transformation and the Hashimoto's Energy Breakthrough. We talk all things weight loss, nutrients that are great, not great for thyroid. We talk about her unique approach and her four types of Hashimoto's patients. And then we also discuss the recent news of the FDA ban on natural desiccated thyroid. So tune in and I am so excited to share this episode with you.

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I am so grateful for you to be here today, Ina. We have been trying to connect and almost connecting for quite some time and I'm just so fascinated with your content, with the information that you share and I'm grateful that you're here to share your message with my people as well. So welcome.

Thank you so much. It's such an honor and I'm so glad we're finally connecting.

Me too. Me too. So I know a lot of your work is around Hashimoto's, which is such a misunderstood thing in medicine. I would love for you to just lay some foundation, give listeners an idea of what Hashimoto's is generally and kind of a discrepancy in your view of it, our view of it, honestly. And then maybe the traditional view of it that hasn't quite evolved yet.

Absolutely. So what's really important to know is that Hashimoto's is an autoimmune disease. So that is when our immune system attacks our thyroid and that attack creates damage to the thyroid and over time it causes our thyroid to slow down. And so often people are told, oh, you have Hashimoto's. Okay, well here's some thyroid medicine and this is where I think a lot of things break down. And just to be clear, I am all for thyroid medicine. I think it's an essential hormone we absolutely need to replace if we need it. Right. But what's really important to think about though with Hashimoto's is that it's actually two things, right? So it's the immune system that is attacking the thyroid and then it's the thyroid that usually becomes slow. And I say usually because it takes some time. And there are some people who have Hashimoto's who have completely normal thyroid labs and that can go on. While those are the people that unfortunately, oh, get so misled and so misinformed because they're told, like I was told about 25 years ago, that your thyroid is fine. We'll just wait and see. Eventually, when your thyroid is destroyed, then and only then will we give you medicine. And this just makes me want to scream because why would we wait and see, right? So it's really about doing both. So it's looking at, okay, well, why is the immune system attacking the thyroid? And there's many different reasons for that. We could get into that as we talk today. And really looking at that, this is what I call triggers and supporting those things because we can absolutely slow down and in a lot of cases stop that immune attack. And that's very, very important because if we don't stop the immune system from attacking the thyroid, what's gonna happen? It's gonna continue to attack and attack, right? Which will then make our thyroid slow down more and more. And very often people are put on thyroid medicine. And then the next year they say, oh, we need a little more medicine. And oh, now you're on 88 and then 100 and then 125. Right. And again, if you need it, you need it. But if you're constantly increasing your medicine, that's a sign that there's something going on, right? And the immune system is attacking and the thyroid is getting more and more destroyed. So it's really this combination approach that's so important. And for so many people, especially kind of going the more conventional route, they're told, oh, you have Hashimoto's and there's nothing to do with weight or they'll say, you have Hashimoto's, I'm gonna give you thyroid medicine for Hashimoto's. And I think this is where it's so tricky, right, because the thyroid medicine is for your thyroid, it's not really for Hashimoto's. And yes, I mean, there's nuances where, you know, thyroid medicine does have an anti inflammatory effect to some degree. So it can help, especially initially in some way, but it's really not specifically for Hashimoto's. And so most people forget to do that. Second, but really important part and a big part which is really addressing the immune system.

Right. And what are some of your favorite. And we can go deeper with this too. But what are your. Some of your favorite ways to address the immune system or what to look for that kind of thing.

So there are so many different reasons as to why the immune system gets confused, and it's going to be someone individual for different people. But I think that there are definitely kind of buckets that most people are going to have something in those buckets. So I call them triggers. And these are things that essentially overwhelm the immune system and confuse it. And so while there's so many different things, I think we could put them into four buckets. So there is the stress bucket, there is the infection bucket, the toxin bucket, and then the food bucket. And there's a lot of different things within that. And so with foods, these are going to be things that you are sensitive to or intolerant to or allergic to, and not allergic necessarily from like an anaphylactic shock situation, but allergic where it's more delayed. And so there's a lot out there on gluten and Hashimoto's, and I think there's so many people who are sensitive to gluten. A lot of people with Hashimoto's have the genetics where they are not able to process gluten properly. And so when they eat gluten, sometimes, even if they don't, you don't feel bad from it, right? If the immune system isn't trained to deal with it, it creates inflammation. And then there's a process, molecular mimicry, where the body actually mistakes gluten for something else. And what's interesting is that it's not identical, right? It's just there's some parts of gluten that have some similarity to things like our thyroid gland, just a little bit. But all we need is that little bit. And when the immune system sees gluten, and especially if you're genetically not prone to process it, the immune system will start to attack the gluten. And then because of this little bit of similarity, it cross reacts and attacks the thyroid. So there's that connection. But it could be anything, right? It could be soy, it could be dairy, it could be corn. I mean, it can be broccoli. Honestly, I mean, everyone is different, which is why it's so important to look at our individual things and our individual sensitivities. But when the immune system is constantly trying to deal with the attack of the food, because we're eating food every day, and if it's something it doesn't like. It becomes confused, and that's how it can turn and start to attack itself. In a nutshell, obviously, it's more complicated than that. But in a nutshell, of course, there's also the leaky gut that comes from having those food sensitivities that creates even more of a response, and that leads into the infection bucket, which is another big part. And so when I talk about infections, I'm not talking about a common cold, though that can sometimes be a trigger as well. I'm talking more about things like more chronic infections, and a lot of them are really beneath the surface. So gut infections like H. Pylori, which lives in the stomach, or Candida, which is a type of fungus or other types of bacteria, it can also be things like viruses, Epstein Barr virus, which is, I have to say, and I'm not sure if you're finding this too, but I have never seen so much EBV reactivation as I have since COVID And we know that because of all that inflammation, right? That old viruses that never really leave our system, they're right underlying, there they come and rear their ugly head, and it's really affecting people. And so these underlying infections, sometimes we may not feel very, very sick from them, but they are there, and they're chronic, and the immune system is trying to fight them. And the way I try to explain it is, think about. It is like if you are constantly fighting something and you're not sleeping well and you're just running, running, running, running, eventually you get really, really tired, and then you may put your keys in the refrigerator and say, what did I do with my keys? Right, because you're just so tired. And so it's the same thing that happens with the immune system. It's constantly getting at it and fighting and trying and not sleeping right, and not resting. And then it just gets tired out, and then it does things that it's not supposed to, like attack your own thyroid. Oops, I didn't know I was too tired, kind of sit situation. And similarly with toxins. So whether it's things like heavy metals, there's such a big affinity with mercury and thyroid. But even things like copper. Copper is an essential mineral, but it can act like a metal when you have too much of it. And, you know, there's pesticides and herbicides and mold toxins. I mean, there's so many different things that we're exposed to. Our liver can only process so much. And for most of us, especially when we have hypothyroidism people don't always realize, but our thyroid actually controls the liver. If the thyroid isn't optimal, our liver is not going to be as optimal. And it becomes not to say that we have a damaged liver, but the liver just becomes more stagnant, less able to do all the things and then all the toxins are coming in. There's so many chemicals in the environment, it's going to affect things. And again that puts more stress and pressure and fatigue on the immune system because it's trying to deal with all of these things and it's just more reason for it to get confused and all these things. I know it's a lot, but it, what's really interesting is that when you address these things, especially if you do them in the right order and it, it really doesn't have to be that hard. People say oh my gosh, it must take years. But not necessarily if you have the right protocol and the right process and things really work together in a body. So it doesn't have to take that long. You just have to know what you're doing and support it correctly. And then we have the stress bucket and I left it for less. But it's definitely not least. And so with that, I think what a lot of people tell me is they say, oh, you know, enough. You don't understand my life. Like you don't even know, right? Like I have children, I have this job and I get it. Right. Like we all have things, however, right? Dress is actually both physical and emotion, right. So if we just take the emotional piece out of it for a second. Just talk about the physical stressors. Well, all of the things we talked about, right. The infections, the toxins, that's already going to help the physical stress. And then things like blood sugar, right? Blood sugar dysregulation is probably one of the biggest physical stressors that a lot of people don't think about. So just balancing our meals and having enough protein and eating regularly, I mean things that are fairly simple that I think most of us can do, it doesn't. I know some of this could be hard, but this isn't that hard. That already eliminates a lot of that physical stress. And then on the emotional stress side, it's of course like I can't understand what everyone is going through. We all have our hardships and all the different things and. Right. There's ways on how we actually think about that stress, right? Like how we process that stress. Because two people can be exposed to the same exact stressor. But Their body is going to receive it in a different way and it's going to be affected in a different way. So sometimes. So it could be even simple things. And I go through a lot of these frameworks with those that I work with, but it's like it could be even simple things like saying I choose to instead of I have to. Right? It's just such a different way, like, oh, my God, I have to eat gluten free today versus like, I choose to eat gluten free because I know it'll make me feel better. Just one word change. But it has a big effect on the nervous system. And so some of those reframes and just ways and we can get into that more, but just ways we can calm the nervous system really plays a big role. And so those are the things that all contribute to that immune system confusion.

I love it. And so, so insightful. And the other thing that I really admire about your approach and that really aligns with mine is we need to find ways that aren't overwhelming.

Right?

We don't need to do all these things. We don't need to change your entire diet based on what works for other people, targeted dietary changes. If someone wanted to take the first step on their Hashimoto's journey, and firsthand, like I do, how fiery people feel, we're tired, we're exhausted, we're foggy. We're like, surviving. Right? If you could have someone take one step or two, if, like, I'm limiting you too much with one in the path towards reversing healing, their Hashimoto's improving it. And I know it's not one size fits all, but give me, like, one of your favorite starting places.

Okay. Gosh, I have to pick one.

Well, no, no pressure.

I mean, I think something that everyone can do is the stress piece. Because I would say, I mean, I. I think in the past, I would say try going gluten free, because that's big and it does really have very positive effects for a lot of people. But I also understand that for someone who maybe is not used to it at all and is used to eating pasta and bread like it's a big undertaking. So while it could be very, very helpful, sometimes that can be a lot, especially if you're doing it on your own. So I think the stress piece is like, first and foremost, knowing that there's something that you can do. I think just having that hope and that understanding. Because so often people are told, well, it's an autoimmune disease, there's Nothing you can do and it's just going to take its course. Right. And then people are told, I mean, I remember I was told like, oh, well, you're too old to have kids or you could never do this. Or like people. Hashimoto's can't do that. And like none of that is true. And just knowing that like anything really is possible. I think that hope is really, really important. And then it's looking at from a diet piece, if we can't, let's say, do the gluten free. Just making sure that we're balancing our blood sugar. So that looks like is not waiting more than four hours between meals. Making sure that every meal has a protein or a fat. And daily protein and a fat. Right. Together. So we're not eating carbs by themselves. And even if they're good carbs, right. Someone could be eating brown rice and veggies. Great. Right. But it's a whole carb, but it's still a carb. If you eat a bowl of brown rice, like you're still going to get some blood sugar rise from that. And so just having that protein and it's amazing how much that makes a difference. And that will. We have to support our thyroid, right? But just the blood sugar regulation can give you enough energy to keep going to then find the answers for you. The other thing I would say though too is just from the thyroid standpoint because for most people with Hashimoto's there is some type of hypothyroidism. I mean, I shouldn't say for everyone, but for a lot of people, right? And some people it's more mild, some people it's progressed more just depending how much the thyroid has been destroyed. So it's so important that you're working with the right provider and to make sure that you get your thyroid medication dose correct. And a lot of people will look at me and say, well, wait a minute, like you do natural things, like you believe in medicine, like they're surprised. But I'm like, no, yeah, like thyroid medicine is a. It's not even a medicine, it's a hormone. Right? You're right.

Amen, sister.

So I think sometimes people are going to do it naturally and so I'm just gonna do this. Right. But it's like if, if you just had the right amount of hormone, like you are ready in such a better place to then tackle all of the other things.

We're so aligned in that. I mean, that is like my leverage point that I give people is look like I'm actually not going to ask you to change anything in your lifestyle until I give you the energy and the capacity and the ability to do it with hormones. Right. Because it is, it's. It's a jumping off point that's incredibly empowering and powerful. So I'm just grateful we align on that. And yeah, I think it's such a black and white. People view it as such a black and white thing. And the beauty is in the both and. Right. The beauty is in you can do all these natural things to preserve your thyroid and reverse Hashimoto's, but you can also take the hormones that your body's missing that you're not magically just going to start producing again if you've lost a significant amount of functional thyroid tissue. I want to change gears a little bit because I just want to mind you, for all the information that we possibly can today, I want to go to an area that I get a ton of questions about, but it's weight loss. Like thyroid, people have a very, very difficult time losing weight. Tell me some of the most common. First of all, why. Why do they have such a hard time losing weight, in your opinion? And what are some common mistakes, some patterns that you see in our people that maybe we could learn from?

Absolutely. So there's many different reasons as to why. I mean, the first is that a lot of times the thyroid is not optimal and literally, like, it is almost impossible to lose weight when you don't have optimal thyroid hormones, especially T3. And I know you talk about that all the time as well, and that's huge. Right. And so because so many people are on a T4, only medication, they may not even know their T3 is low. Right. That's a big thing.

Or what is T3? Can you tell people like T3, T4 and medication so they can have an idea?

Of course, absolutely. So T4 is our pro hormone. So our thyroid produces mostly T4. It produces a little bit T3, but a very, very small amount. And people often ask, well, why is that? Our bodies are really smart. So nothing is done just because. Right. We need thyroid hormone for literally everything, our head to our toe. Right. And so if we had a lot of T3 produced in the thyroid, it would be used by the cells here and there wouldn't be enough to go all around. So the body's so smart. And it produces a T4, T4 then has to convert to T3, but it doesn't do it in the thyroid. It does it in other areas of the body. So the T4 then travels to our liver, into our gut, where it converts. And hormones are kind of like children. So we don't just let children roam around on their own. So hormones don't travel on their own. They travel on protein. So I always say to people, think of it as like they get on a bus or they get on a truck and then they drive to those areas, they convert there, and then the converted hormones go to the cells that need them. And so the T3 is that active hormone, and the active hormone is really what does all the work. And obviously, of course, we need T4 and there's reasons for that, but T3 is what does the work. And I find it's really important to test for both the total and the free, as you do as well, because we really have to look at what's bound to proteins on the bus, so to speak, and what is available and free, because the free hormone accounts for a very, very, very small percentage of all of the hormones. So if we go by that only there are. I mean, it's still very. It's very important, of course, but I like to do both because there is a lot of nuances and patterns we can miss if we just look at one. But T3 is extremely important. And if we don't have enough T3, it's going to be harder for many, many different things, including losing weight. But also because Hashimoto's is an autoimmune, we know that it's an. It's an inflammatory condition, right? So people with Hashimoto's. And again, I don't want to generalize, but typically, right, we are prone to having more inflammation. And what's interesting too is most people think that inflammation is just in the thyroid, but it's not just in the thyroid, it's everywhere. Because that autoimmune attack, while it attacks the thyroid, it can create increased inflammation in our joints, right in our brain, like everywhere. And so that inflammation also makes it harder to lose weight. Oftentimes with Hashimoto's we have blood sugar issues, so we might be more insulin resistant, and we just may not process food in the same way. So that's another thing that kind of adds and it becomes this triple whammy. I mean, there's other two, but I'd say the biggest is probably not enough thyroid hormones, especially T3 inflammation and blood sugar issues. And just how we burn fat is not as efficient. And again, I don't want to generalize, but when our thyroid is not optimal, then we may not build muscle in the same way. And so we may have more fat and less muscle, and that ratio also makes it harder. And of course, on top of that, we're more tired. So if we're more tired, we can't exercise as well. Right. And it's just this like, vicious cycle. And so what I find really helpful for weight loss is getting the thyroid right and really optimizing it specifically for the person's specific thyroid pattern, then really balancing blood sugar in like a thyroid smart way. And I find higher protein really helpful sometimes, and it depends on the person, but really looking at the ratio of the fat and the carbs, because obviously we don't want to be on a low fat bandwagon. Obviously fat's good for us, but fat is still calories. Right. And it's really getting the macros right for where their current metabolism is, and that really helps.

I love it. Yeah, that's so, so insightful and spot on.

Right.

I mean, it's, it is this multifaceted approach and it's so complex. These people struggle. I mean, that's like the biggest thing I find. Even when their numbers are perfect, weight loss is the last thing to improve. So, yeah, we absolutely align on that. Tell me a little bit about. Well, anything else you want to mention about metabolism, weight loss, even exercise. Anything else that you want to throw in before I pivot.

The other thing I would say. And again, just going back to that hope, right. Like, just because you have Hashimoto's, please do not think that you are going to have this extra 5, 10, 15, 20 pounds. Right. There are things that you can do so many different things and they don't have to be hard. And I think it's not about pushing. Right. And from an exercise perspective, too, more exercise, especially in the beginning, is not better because the body treats exercise as a stress. And if your body already has higher cortisol and already stressed from these other triggers, it's going to add on to that and then you will actually gain weight instead of lose weight. And I always tell people that it's really important to listen to your body. If you do a workout and you feel tired after that, it is a sign it was too much even.

Amen.

You know, and the thing is, people say to me, but, but I just went for a walk. I'm like, well, guess what? We're not ready yet. Right? Like, and that doesn't mean you could never go for a walk. It's amazing. With the right thyroid support, with the right nutrients, you know how much things can Build up quickly. Same thing as with working out, right? Like we lift 5 pounds the next week, we can lift 10, or we can run a mile, then we can run two eventually. Right? But it's not blaming yourself or feeling like a failure, but doing what you can. And if it's too much, you go down a little bit. And then we work on it and we build up.

Amen. And just because it's so right now doesn't mean it will be that way forever. I mean, that's the trap people get into is, well, what if I can never go for a walk and tolerate it again? Or what if I can never lift weights again? And that's. You rest your way out of that situation. You rest initially, you really work on all these other components and then your resilience goes up. And as it goes up and continues to improve and increase, guess what? So does your exercise tolerance. And I totally agree. One of the most dangerous patterns I see are those people that continue to push through and they decline, decline and get worse and worse because they're not getting stronger, they're getting weaker. Right?

Yeah. Such.

Such good wisdom. Talk to me a little bit. Let's change gears again and let's talk nutrients. So there are so many studies of looking at targeted and specific nutrients that are really, really great for the thyroid. I know there are some that are not great for your thyroid. I'd love your take on this and give us any thought.

So there are so many important nutrients for thyroid. I mean, I would say probably some of the biggest are going to be selenium and zinc and inositol. So, Selena, so much research on selenium. There's research on selenium can even lower thyroid antibodies. Selenium helps with T4 to 3 conversion. There's a study talking about both selenium and inositol together, working on both lowering thyroid antibodies and TSH as well. What's really cool about inositol, specifically myo. Inositol, is that it can sensitize tsh. So the study showed like a little bit more than a 1 point decrease in TSH without. So I love those nutrients. And both selenium and zinc help with T4, T3 conversion. I think B vitamins are really, really important. And I think many people know that we want to stay away from synthetic B vitamins like folic acid or cyanocobalabin. That's synthetic folic acid and synthetic B12. But you know what I also find, and I'm one of these people, is that Too much methylated. And of course we don't want anything synthetic, but we want more methylated. But too much methylated bees can be a problem too. For those of us who are over methylators, I'm one of them. And I found out the hard way, gosh, this was probably right when I was starting my practice 20 years ago and I was kind of doing it all. I'm like, okay, this is goodness. I'm gonna take this and this and this. That's partly why I have my Thyro Love supplement now, because I would take everything thinking it was good, not realizing they have to be really paired together. And I, I felt like. I mean, I had energy, but I literally felt like I was falling out of my skin and I was anxious and I thought I was on too much thyroid medicine. But when I tested, I wasn't. My numbers were good. And it wasn't until I looked at my homocysteine, which is one of the methylation markers. It was 2.5. So for everyone listening, that's very, very low. And we don't want homocysteine to be very high because that means that we're not methylating properly. But everything. There's both sides, right? We want to be in that golden middle. And so it went the other way. In a very low homocysteine. There's many different things, but having being over methylated is part of that. And I switched from. And again, I'm not. I wasn't doing synthetic B vitamins. I was just doing the natural non methylated. So that was folinic acid versus the methyl tetrahydrofolate or adenosylcobalabin and hydroxycobalamin versus methyl. And now I'm pretty balanced where I could do a little bit, but I still need some of these others. If I do too much methylfolate or methyl B12, still feel it. I get that weird anxiety feeling. And I know right away, oh, that's what it is. Absolutely.

I'm not alone in that.

There's. And I don't know if it's Hashimoto's makes us. I mean, I think there's obviously genetics or so many different things. I don't think it's just Hashimoto's, but I've seen. Just because I work mostly with the Hashimoto's population, I've seen a lot of people who have Hashimoto's bee over methylators as well. So these are important. But I just mentioned this because we want to make sure we take the right Bees. Iron is another big one. So iron is so important for everything. Our energy, our hair, our skin, just with how oxygen carries. Carries. Right. And so with that, there's many different reasons why people with hypothyroidism and Hashimoto's can be low in iron. It could be because of heavy periods and losing a lot of blood. It could be because the thyroid is going to control what happens in the gut. And if our thyroid is not optimal, we can have more leaky gut because the thyroid controls all of our membranes. And with more leaky gut. Right. We're not going to have as good of an absorption. We may have low stomach acid, which is really common of hypothyroidism. You need iron to. Sorry, you need stomach acid to absorb iron. The food sensitivities can affect it. If our motility is slow, that can affect things too. So it's really important to test for iron, both total iron and iron saturation. And ferritin. I do usually tell people just to be careful not to go by ferritin alone because sometimes that could be a little tricky. But looking at all of them together to see if you need iron, that's another really, really important one.

Absolutely, yeah.

Calcium, magnesium. I would say even more magnesium than calcium. It's amazing how much calcium we get from food, even if they're not dairy products. We don't realize. And when I test people, and I'll do hair analysis sometimes and people, I'll often see lower levels of magnesium as compared to levels of calcium in their tissues. So magnesium is really, really important and that can help with a lot of symptoms as well. Magnesium is good for getting that restful sleep, for stress, for motility, for just overall nervous system calming.

And I think a lot of people take like a Cal mag supplement together and that just doesn't work well. Those two things compete. And so I always tell people, look, if you're going to take both, you want to separate them. They definitely are competitive with one another. And I totally agree. Most people are magnesium deficient. Many of us are not as calcium deficient as we are afraid that we are. Right. Do you see the same thing all the time?

All the time. And too much calcium will build up and then create all these other issues too. And I know so often people think, oh, well, I need it for my bones. But without the magnesium, without the K, without the D, actually makes things worse.

Totally. Tell me your thoughts. I know we didn't plan on talking about this, but I'm just picking your brain here. Tell me Your thoughts on iodine.

So I am not a fan of iodine with Hashimoto's and there's a lot of research and that's not just me. And I think you're.

I'm the same.

Yeah. So. So here's what's interesting. Too much iodine. Well, iodine in general, right. Could create a flare. Right. It's contraindicated for Hashimoto's. But iodine is helpful for thyroid hormone. Right. Iodine is helpful for breast tissue. And so the question I always get is like, well, how. What do I do? Right? And it is one of those things. But I, for me. And you tell me if you agree. But I think we need to kind of look at Hashimoto's first and foremost because we don't want to flare things up. And most people are not deficient in. I like, I just don't see that. And I'd love to pick your brain, actually, while talking about this, about iodine testing, because those are so tricky because there are some tests where you take iodine and then you do a 24 hour urine and sometimes it shows like you're deficient because it doesn't come out. But they're very tricky. I just don't know if you could try like a lot of the stuff I don't trust same.

I do not trust it. And I used to do like urinary iodine testing on everyone and I didn't find it reliable, to be honest. Like, in the end I'm like, yeah, no, this isn't working. This isn't valid. And I'm kind of the person who. I will do anything to collect the data and then I'll make a decision. And if I don't think it's real, if I don't think it's working, if I don't think it's valid, I'll drop it. I won't continue. But I'm always open. I'll go into it with an open mind. But no, I totally agree. I think iodine deficiency, everyone is assuming there's a high frequency and incidence of iodine deficiency and there just isn't nowadays. No, it's. We use iodized salt alone anytime we eat out, even if we use Himalayan salt at home, we get exposed to enough elsewhere, we get exposed to by breathing, breathing it in, in the air, you know, and coastal environments, obviously more than inland. But yeah. The reality is, is most of us aren't iodine deficient. And it's certainly. I completely agree. It can put us into a flare and we don't want to risk that. And everything's about risk versus benefit. And I don't, I don't think it's worth it.

Yeah, absolutely. And there are in some of my programs for people who are really in a flare, I actually have them go on. I know, Iodine diet. Yeah. So there's benefit there. And let me tell you a story with iodine, because when I was younger, as I was starting my practice and kind of dealing with my own issues, I followed a popular doctor who really talks about the benefit of high dose iodine. And so I did the test and of course I took 50, not micrograms, but milligrams. Right. So high dose iodine. And nothing came out in the urine. And they're like, oh, you really need it. And so I started taking it. And within three weeks, I like, couldn't even touch my neck. Like, it was so tender and sore. And I remember, like, I mean, I didn't have kids then, but I think my husband, like hugged me and I was like, oh, oh my gosh. Like, it was so tender and like, I mean, I didn't even realize it was swollen because again, I was just at the very beginning stages of learning about this. This was 20 years ago. And then I got a cold. And then I remember the person was saying, like, oh, but everyone does so well, even with Kashimoto's. Just keep going. And so, like, I did. And then I remember getting another cold, like two weeks later, and then another. Like, I just kept getting sick and it was this whole big thing and I felt awful and my TSH went up, which they say, well, that's normal. When you take iodine. That's what happens. Your TSH goes up. But I was like, well, my tsh, that's six now. Like, this doesn't really make.

When is it not normal? Like, when is my response to this not normal? And you should take.

My antibodies were through the roof. Like, And I was like, yeah, okay. Like, no. And granted, I was on extremely, extremely high doses. But you know that bullets don't have.

Neuroethones or high doses, right? Like, they think that's normal.

Well, because the protocol was you take this high dose and you heal your Hashimoto's and it's like, no. And Again, this is 20 years ago. We know more now. But just I have, I. I try before I give it to anyone. I tried all myself. So I've done it, tried it all, and no, not good.

Yeah, I mean, every day I'm sure it's the exact same for you. Every day when I'm talking about anything on thyroid on social media, I get comments. Why aren't you guys all just doing iodine to heal your thigh? I literally got that yesterday. And then there's a slew of people responding. Right. But it still is very much touted as the natural method to heal your thyroid. And it's a bit dangerous in rhetoric. I mean, I had the same experience who. When Alan Christensen's book came out on thyroid. I forget the name. Anyway, it's one of his more recent books and one of my patients who had been stalled in their antibody reduction for years. She had been my patient for years and years and years. We put her on the diet and it moved them so much after they had already plateaued so firmly. So I've definitely seen the iodine removal, even in the most difficult cases, improve. Yeah.

So. And, you know, it's also interesting, a lot of times the people who comment on the post, like, do more ida. They'll say, oh, it's because you are deficient in selenium or because there's like, bromide or other stuff. But I just don't find that to be the case. Like, I've had people try doing and selenium together. It didn't help.

Right, right. But it. And it's funny, like, you have to be dangerous. I mean, you have to realize it's dangerous when there's constant justifications for all of these things that are happening. Oh, this is normal. Oh, you need more. Oh, you need this other nutrient. Like, no, my TSH shouldn't be six. No, my antibodies shouldn't be sky rising. Something's wrong, something's off. Right. But sometimes we get so rigid in our ideologies that we refuse to see the truth. I think I know that you talk a lot about thyroid patterns, and I find this so useful and beneficial for these people who are navigating the. The really, really complex landscape of all of this. I would love to tell, for you to tell us about thyroid patterns, why it's so important to understand yours and give listeners who might not have been exposed to this concept the rundown.

Yeah. So thyroid patterns are essentially the way your hypothyroidism is expressing. If you. Right. So two people can both have hypothyroidism, but what makes their thyroid slow, so to speak. Right. Is going to be different. So in order to understand those, we want to just make sure we're all on the same page about how thyroid hormone is produced. So we touched on that A little bit before, but just to give people, like a little summary, right? So our brain is. Our pituitary specifically, is going to stimulate the thyroid to produce thyroid hormones. And it does that with the hormone TSH, which I think everyone who's a thyroid patient knows TSH, right? And then our thyroid is going to produce T4 with a tiny little bit of T3. That T4 then is going to get on our trucks and buses, right? And travel to the liver and the gut where it's going to convert. And then from there it's going to. The converted T3 with the T4 is going to travel to the cells where hopefully the cells are going to accept them. And then they. The hormones would then jump off the bus or the truck and knock on the door of the cell, which is the receptor, right? And then get inside. And so there's a lot of steps in this, right? It's not like brain produce hormone cell. Here it is, right? It's like five different steps. And so essentially the patterns are where things break down for you, right? I call those thyroid types. So someone may be producing enough tsh, right? A good amount of tsh. They are going to stimulate their thyroid. The thyroid is going to produce T4, but then maybe they're not converting to T3. This is probably one of the most common ones, right? So I call that the low T3 type. Someone else might be producing the TSH, Tyrus, producing the hormone. They might be converting the hormone just fine. But maybe they, the hormones get on the bus and maybe for them, those buses that drive around the south for some reason, like lost their brakes and they can't stop or their doors won't open, right? And so you have all of these hormones and these buses packed with hormones, but they can't get off the bus. And so for them, they're. I call it the unavailable type because literally the hormones there, but it's unavailable to your cells. And so it would be very different what you would do in those situations versus the situations of the low T3. Right? Because for people who have low T3, we would want to look at, okay, well, why is it not converting? There's things we can do to support liver and gut. And for a lot of people, especially with Hashimoto's, it could also be just that they need the T3, whether that's an NDT or just T3, as in something like Cytomel or compounded synthetic T3. Right. Because some people just don't convert for various reasons. Hashimoto's itself Sometimes just inflames the areas where the conversion happens. So we would need that versus for people who have the unavailable type. Right. If you give them more medicine, that's not going to help because it's just going to sit on the bus and it's not going to get off. And so for those thyroid types, we want to really look at some of the other hormones, like what's going on with their estrogen, their progesterone. Interestingly, with an unavailable thyro type, I find a lot of people who have pcos, people who have fertility issues are more prone for that pattern. Again, I mean, I don't want to generalize, but I just see that a lot. And then there's also one where someone may have Hashimoto's and all their thyroid hormones are actually okay, like really truly okay and in range. And by the way too, when I say okay, I'm talking about, as you talk about, right, optimal range. I'm not talking about like being in this really wide range and you're on the very low end or very high end of that. You were kind of in the middle of the optimal range. But sometimes they may have all normal hormones, right? I call it the Hashimoto's all normal type. And that doesn't mean you do nothing, that just means that, okay, it's normal now we gotta support those triggers, get the inflammation down so it stays normal. For some people, they have kind of very traditional high tsh. And so I think for most people who have hypothyroidism, they know, okay, like my TSH high, we need something. But a lot of people don't realize there's different subtypes of that. So I classify them as subtype 1, 2 and 3 where it, like the TSH sometimes could be high, but hormones are normal versus TSH high and hormones are low. And you would do different things for each of those scenarios. And so that's where it's so important to know because I've seen so many cases where someone may have a high TSH and normal hormones and they're put on thyroid medicine and they feel terrible. And the doctor's like, well, your TSH is at a 10, you have to take thyroid medicine, right. Meanwhile, and again, this is obviously for educational purposes. I'm not telling anyone to not take their medicine, not follow their doctor. But I'm just explaining that if TSH is high, but hormones are normal, there's something else happening that's inflammatory. It may not mean that you actually need this high level of thyroid Hormone and again, not for every person. But that's where a lot of people feel terrible. They have anxiety, they have all the hyper symptoms. So it's really figure out, okay, but why is it there? And what's really interesting and important to know about these thyroid types is that there's an underlying reason each of them. Right. And so you want to support each type for you and get to the underlying reason so that then we can correct the type. And the types also change throughout our life. So pregnancy, postpartum can shift things, stress can shift things. And then of course once we're on medication it fixes that type. But sometimes if something goes off, we can become another type because the medication is skewing us in a different direction. So it is something that you want to be aware of and monitor throughout. I love it.

So insightful. I want to close with. So we spoke about this before we hopped on. It is a big week in the world of thyroid in that a few days ago the FDA sent a letter out to prescribers requesting that we begin to transition our patients off of a type of medication called natural desiccated thyroid. These are drugs like Armour, NP, Retin Thyroid and they gave us a 12 month deadline to do so. And two of these medications, Armor and Rethyroid have already begun and are in the early process of application for FDA approval but they will not be finished in 12 months. And so we expect a gap in people's access to these medications. Desiccated thyroid absolutely changed my life personally. I was in the throes of my own very severe thyroid battle when I was transitioned to them and they gave me back my life. And I know there are millions of people who feel the same way. I would love for you to speak a little bit to this and tell us your personal or professional what you've seen with these medications and maybe an ask an FDA ask of what we could do to keep access.

And I know we've been talking and we've been talking to our thyroid colleagues because this is a big deal and with these medications they are animal derived and so they work slightly differently in the body than the synthetic and everyone is very different. For me, I actually did better on the synthetic than those that those raised my antibodies. But we're all different, right? And I know so many people who go on synthetics and feel terrible. I mean I, we've all been posting about it obviously and like I've hundreds and hundreds of comments of people saying how much it helped them. So. And it's changing medications is A whole other thing. And sometimes, yes, like, that needs to happen, but that, I mean, there's a lot of. I mean, I don't want to say trial and error because knowing the numbers, we can hopefully find the things that are going to fit.

But it's just an incredibly difficult transition, like it really is, from synthetic to that and not to synthetic. Different half lives, everything.

Exactly. And it's also just the energetics of it. Right. So, like, even just dosage aside and like, because we know, right. That NDT has 39 micrograms of T4 and 9 micrograms of T3. Right. We know it's like an 80, 20 or is 85, 50, 80 20, I think, ratio. Right. So, like, we know the science of that, but there's so much more. It's kind of like saying, like, oh, vitamin C, eat an orange. But you're going to get a different, like, effect for an orange versus a vitamin C tablet. Right. So there's so much there. And that's why we're all doing everything that we can and trying to get everyone involved to. To delay this and to do what we can so people can have access to their medications. I think that for some people, they'll say, oh, well, I don't do as well on level than I do on NDT. And in those cases, adding T3 to the diet can help them think that it goes further than that. Because it's not just T4 and T3, it's everything else of just all these medications are tried and then there's the T1 and T2. Right. And then we don't actually even know exactly how they work, but they have a different effect. Yeah.

And I think there inherently needs to be choice.

Right.

Like, patients deserve access to more than one class of each type of medication. Like, I think we are in a country where we value that so much from the top down and so kind of taking that away from people and giving them essential 1t4 option and 1t3 option. Obviously there's brand name differences, but that's. We have access to things that have been safely and effectively used for over a hundred years, and it's sad to think of us losing that access. So I appreciate you speaking to that. I appreciate your support in our efforts of trying to save ndt. And of course we'll share more and more in the days and weeks to come and how everyone else can get involved in that. But I feel confident that we are going to create a movement that will allow us to maintain access while we wait for FDA approval of these meds. And thank you so much for being here today. Thank you for your work and dedication to this community. We need that, like, people need access to the information that you're providing. And I'm so grateful to be able to share your voice with my people.

Well, thank you so much, and thank you for all that you do. And it was such an honor connecting with you, talking with you today.