A short YouTube talk by McCall McPherson (founder, Modern Thyroid Clinic) arguing that persistent thyroid symptoms (fatigue, brain fog, weight gain) despite T4-only therapy are commonly caused by a "conversion disorder"—impaired conversion of inactive T4 to active T3. She lists factors that suppress conversion (inflammation, low micronutrients or protein, calorie restriction, chronic stress/poor sleep, pregnancy) and recommends low-inflammatory, nutrient-dense diets, sufficient calories/protein, stress reduction and sleep improvement to support conversion. When lifestyle measures are insufficient, she advises clinicians to consider prescribing T3-containing medications (liothyronine/Cytomel, Armour) to restore active hormone balance and improve symptoms.
Chapters
If you have symptoms of a thyroid disorder like fatigue and brain fog and weight gain and you're on medication, but your symptoms aren't going away and you can't seem to figure out why you're not getting better, there's usually one core reason that is like the foundational piece that most everyone needs to fix. I will tell you what that is, what to do about it at various stages. So yes, we will talk about all that. If you don't know who I am, I'm a pa. I'm the founder of Modern Thyroid Clinic. So all I do all day is give people their lives back. People with like the most complicated, complex thyroid disorders out there. And my success rate is, dare I say, unparalleled. So the core issue that most of these people have, that literally 100% of the people that come to Modern Thyroid Clinic have, is what I call a conversion disorder. They are not able to convert their inactive hormone or T4 to their active hormone T3. And most people either they have enough of their own inactive hormone to convert or they're taking Synthroid or lithothrift thyroxine, which is all inactive hormone and it needs to be converted as well. Well, there are lots of things that influence the conversion of our hormones. Our body wants us to activate our thyroid hormones when we're ready to procreate. That way we have energy, clarity, all these things we're able to function in society when we don't have these core basic needs. Our body doesn't activate that hormone. And what it actually does is it sequesters it to the inactive state state and it keeps us from having energy capacity. Basically it makes you lay down, rest and recover so that you can get well. Your body purposefully limits your energy source so that you will rest and recover. So things that influence that activation or the conversion of those hormones are inflammation. So eating a low inflammatory diet, things like low gluten, no gluten, no dairy, that kind of thing. Low micronutrients or low protein will sequester your inactive hormone and keep it from activating. So making sure you're getting a well balanced diet with high dense nutrient density and enough protein, enough calories over restriction will sequester and not allow your body to activate that hormone sickness. Stress. So chronically stressed people, people who aren't sleeping. Pregnancy is a classic like un physiologically normal state where your body wants you to lay down, rest and recover. So one of the mechanisms it makes us tight tired by doing making us tired during pregnancy is sequestering our thyroid hormones not allowing them to activate to T3. So stress reduction, meditation, low inflammation, enough micronutrients, all of those types of things can help to propagate your hormones to activate so that you can actually feel. Well, if you can't activate them, you feel horrible, guys. Now, a lot of people, and these are the people that come to modern thyroid clinic, are people who've tried so many of these things, but the activation of their hormones are still subpar, they are insufficient. And this is a massive, massive, massive problem in our country and in the world. And it is the single reason, I mean, the biggest reason, in my opinion, that people with thyroid conditions are suffering needlessly for their whole lives. They're being given only medications with inactive hormone. If you can balance their active hormone by giving them a medication with active hormone, then they get their lives back, right? Because some people can lifestyle their way out of poor conversion and eat well and meditate and all the things, but other people can't. Their conversion does not improve enough for them to feel good, to have vitality, to have energy, clarity to metabolism. And those people need to supplement with medications like lyothyronine, cytomel or armor, things with T3 in them that need to be prescribed and given by a clinician. So.