Webinar: Uncovering the Root Cause of Hypothyroidism and Hashimoto's Disease

Tonight's talk is going to be called Addressing the Root Cause of Hypothyroidism and Hashimoto's. And this topic is pretty near and dear to me because not only does my grandmother have it, my mom has it, and my father also has dysfunctional thyroid. And what I see in my practice really breaks my heart because many women lose the best years of their life suffering from autoimmune disease and thyroid disease in particular. And unfortunately they don't get diagnosed properly or instead of being treated as a human being, their clinicians simply treat paperwork. And so you can go into the doctor and be told everything is normal and not feel well, not look well and not know where to turn. So I'm really glad that you're here joining us tonight and I hope that this information changes your life. I know it's changed my life personally and those near and dear to me and especially my patients. I'm really honored to be able to share this evening with you. Not sure where you are. Many of you are joining us from across the United States and where I am it's rainy and dreary. But I'm really looking forward to brightening up your day. So let's get started and we've got a lot of information to cover. You're going to find this information fascinating and interesting at the same time. And I will warn you that I never tell any of my listeners to take what I'm saying for face value. I want you to do your own research and your own due diligence because a lot of this information is going to be very new to you. So don't believe everything I say. Do your own research and come to your own conclusion. And what you'll find is that everything I'm telling you is the truth and it's backed by science, which is obviously very important. Let's start off with a quick notice that this lecture is not intended to diagnose or treat your current health issues. That should be obvious. And everything I'm going to say is backed by peer reviewed literature and most importantly, common sense. And that's very important too, because what we say has to make sense and if it makes sense, then it's easy to digest. And I want you to silence your cell phones or other distractions. This talk can really change your life. So pay attention. This talk is being recorded. You will be sent a replay and that way you can view it over and over if you wish to. Or what I would suggest is you can even share it with other people at our practice. The Living Proof Institute. We believe that nothing will ever fix your body better than your body can fix itself. We're blessed with a body that has intelligence, with a body that knows what to do when it's provided with the right environment, the right nutrients and the right input. So it's very critical that we give our body a lot more credit than most people do. Our body does a million millions and millions and millions of things every day for us. And it's unfortunate because a lot of times patients come into my practice and they feel like their body is working against them. And it can seem like that sometimes, but I always remind them, if your body didn't want you alive, all it has to do is stop breathing for four minutes. And clearly it hasn't done that because you're here. So now let's tap into that innate healing potential and help your body find balance in homeostasis, because that's all it knows how to do. It's constantly fighting for balance and homeostasis. So if we can move you in that direction, whether it's through lifestyle, whether it's through diet, whether it's through eliminating toxins in your environment, whether it's giving your body more of the nutrients that it needs, whether it's fixing the immune system, because that's what you're going to learn about tonight, then let's do that, because then it gives your body a fair chance to get better and to heal and to do what it knows how to do, which is to be balanced and functioning optimally. Just a little bit about me. I know this is more about you guys tonight, but I think you should know who you're talking, who's speaking tonight. I'm a functional lifestyle medicine practitioner, and really what that means is we take a very personalized approach when it comes to addressing our patients, chronic illnesses. So instead of focusing on the diagnosis, which I do feel is important, what we focus on is the human being that's sitting in front of us. And understand that that individual has unique needs, has unique goals, has a unique environment, has unique genetics. And a cookie cutter approach is not going to work. So doing this workshop, whether it's online, in a webinar format or even live, is very difficult because every one of you has unique needs. So the recommendations I'm going to make are not going to be to everyone. Some of these things may apply to you more than others, and some of them might not apply to you. So what you're going to learn today is going to be very practical, but it's very important. To understand that each of you has unique needs. So what works for you might not work for the next person. I also founded the Living Proof Institute three years ago, and I'm proud to say that our organization is expanding quite rapidly to meet the demands of the current climate of healthcare. And I hope that that changes. I hope that there's less sick people. And that's part of our mission, is to ensure that by educating individuals, especially through workshops like this. I also co founded Thyroid Bootcamp. That's probably how most of you heard of this workshop. And that was a brainchild of mine and my partner, Dr. Jared's. And we decided, let's educate people. Let's give people the ability to make an informed decision when it comes to their thyroid health, because that's what's missing. People are missing information these days, and it's quite sad and unfortunate to me, but I think that's the missing link. People would make better decisions had they been given the right information at the right time in their life. I'm also a clinical mentor and educator, so I do work with other clinicians around the United States and Canada, helping them optimize their protocols for their patients and also build their practices so that we can have more people with a similar mindset, more practitioners with a similar mindset working with patients all over the country. My goal, very similar to Steve Jobs, is to really make a dent in healthcare. And I feel that we have the tools that to do that now we just need to get the message out there. I'm also a corporate health consultant, so I work with companies like General Electric and Whole Foods and ING Direct and Gorilla Glue and a bunch of other companies. And they hire me to come in and educate their clients and their employees on how to live a healthy life. Because of course, with the staggering cost of healthcare, employers want their employees to be as healthy as possible as well. I'm also a certified gluten free practitioner, which means I, I have a much more in depth understanding of gluten, which you'll learn a little about to little bit about tonight. Gluten is a big contributor to many chronic diseases and in particular thyroid disease. Our practice is a certified practice, which means that our practitioners understand gluten in a very in depth way. And none of our products or protocols contain gluten, so they're all gluten free. And I'm also a speaker for the American Diabetes association because the protocols that we use and the type of care that we provide has an amazing effect on patients who are diabetic. So I speak all over the country for the American Diabetes association. And most importantly, I'm a proud son, father, and husband. And I really love that role in my life because that's the role that gives me the most joy. So if you have questions, here's ways that you can connect with us. I encourage you to, at the end of this appointment, at the end of this meeting and webinar if you feel like you want to come in and. Or really sit down and talk to somebody, we're here to help you. So you can always schedule an appointment. You can send me emails directly to. My email address is listed there. Check out our website, learn more about what we do. You can connect with us on Facebook and also on Twitter, and that's where we post a lot of great information that might also help you as well. So let's talk about why it's time for a smarter approach. We've got a staggering increase in the cost of health care. People are getting sicker every year, unfortunately. And we believe, honestly, that functional medicine is one of the most important advances in medicine because it provides us with objective tools to identify the underlying causes of chronic disease and gives us a strategy on how to correct them. And lifestyle medicine is basically using lifestyle as a tool to heal the patient as well. Most people that I see have a lifestyle disorder, and it's because of that lifestyle disorder. They're in my practice right now. And had they been taught and been given the tools on how to live a healthy lifestyle from a very young age, then guess what? They probably wouldn't be in my practice. A little bit background about myself and my journey when it comes to health. I used to suffer from chronic fatigue myself. And, you know, for many, many years, I searched for answers. I had chronic acne. I had chronic constipation. And I just thought these things were normal. A normal part of growing up and going through puberty and, you know, the aging process. And what I realized is that they're not, because if they were, then everyone would have them. But later on in life, I realized that gluten was a big part of my issue, as well as dairy and other problematic foods. And I also had certain nutrient deficiencies that were caused by poor dietary choices. Growing up as a vegetarian, one of my biggest dilemmas always was, you know, the biggest problems in the vegetarian diet is the heavy carb intake. And so I would feel lethargic all the time. And what I realize now is that that diet just wasn't right for me. And I was eating foods that were Problematic for me. And as soon as I eliminated those foods from my diet, I was already living a healthy lifestyle. I was exercising, I was sleeping enough, I was doing on paper all the right things, but my diet was a contributing factor. And that led to chronic fatigue and allergies, constipation, as I mentioned. And it also led to me being very unfocused in what I needed to do. And once I encountered a clinician that really treated me as a human being instead of a diagnosis, I was able to address these underlying issues. And now a very, very functional, highly functional individual. And I just love waking up every morning and having all the energy that I have. So functional and lifestyle medicine really is the future of healthcare. And many of you are probably frustrated because your doctors aren't taking that individualized approach. So let's briefly, let's talk about functional medicine. I can sum it up in this one image. When you go to your doctor, essentially what your doctor is trying to do and what's required by them by the insurance companies is that they have to come up with a diagnosis. They have to basically take all the complaints that you have and come up with a single five digit code. And that's, to me, that's just impossible. We're asking our doctors to do something that is impossible. And you know, really on the form, there's only four slots. So you can only come up with four different diagnosis codes. And then guess what? 38% of the time, according to the New England Journal of Medicine, the diagnosis is wrong, which means that 4 out of 10 people are getting the wrong treatment. Because the diagnosis is what governs the treatment. And the unfortunate consequence of that is that you get sicker. And band aid solutions are then applied. What we focus on is what's going on under the surface. So things like inflammation, stress, poor diet, toxicity, a lack of sleep, poor relationships, nutrient depletions, a lack of exercise, toxic thinking, trauma, whether it's emotional or physical, genetics, and poor digestion. These are the things that we can actually change, that we can control. And these are the things that unfortunately lead to chronic diseases. So inflammation, for example, is at the root of many, many chronic issues like hormone imbalances like thyroid disease, like anxiety and depression, like high blood pressure, heart disease, autoimmune diseases, all of these things are fueled by chronic inflammation. And chronic inflammation is fueled by, you know, a toxic environment and also toxic behaviors like smoking, for example. But it can also be fueled by food allergies. It could be fueled by mold in your home. It could be fueled by certain Foods that are creating an autoimmune reaction in your body. So there's many, many things that can contribute to inflammation. Even certain essential fatty acid deficiencies can contribute to an inflammatory, imbalanced, inflammatory response by the body. So if we can figure out if a patient has inflammation and address that at the root cause, well, we've lowered their risk of developing virtually every illness that's chronic. And so that's important to understand because that gives us a huge roi. And what I tell my patients is that if I really do my job well, you're not going to really see the benefit of what I do, because you're just not going to get sick. And that's what our patients experience when they go through our program and through this process of getting healthier. Let's focus on getting healthier instead of focusing on treating your thyroid, because when you get healthy, that's where all the magic happens. Healthy people don't have thyroid disease, so let's make that our goal. So as we get started, let's start talking about the thyroid specifically. Now, the thyroid is an interesting gland because the thyroid hormone basically affects every organ in your body. And when we look at the different systems that are impacted by the thyroid and, and all the different conditions that are related to thyroid hormone dysfunction, it's really disheartening because, you know, virtually every receptor, every cell in your body has a receptor site for thyroid hormone. So this can lead to many, many systems breaking down or not functioning properly. So, for example, in the throat, it can create difficulty swallowing, an enlarged thyroid gland, which is a goiter, a hoarseness, or change in your voice. In the brain, it can create fogginess, low motivation, depression, anxiety, fatigue, a hard time dealing with stress. The heart can either be slow, the heart rate can be slow, or fast. Patients might experience palpitations. The hair, skin, and nails might change their texture and their strength, so the hair might become dry and lifeless. Patients might experience hair loss, brittle nails, dry skin dry, and cracked heels. Many patients will retain extra fluid, so they might experience carpal tunnel syndrome. Digestion becomes compromised because our stomach relies on thyroid hormone to make gastrin, and gastrin is what makes our gastric enzymes. So digestion can be compromised, and this leads to constipation, bloating, gas pain, obviously low stomach acid production, gallstones, and also liver dysfunction as well. Many patients, you know, their main complaint is constipation. And just keep in mind that when your thyroid isn't functioning properly or when the hormones aren't balanced, then everything tends to Slow down. So this can lead to weight gain as well. Sex organs could also be impacted. So this can lead to menstrual irregularities, pcos, low libido, infertility, frequent miscarriages. And patients might also experience swelling in the legs, spider veins, varicose veins. So there's a variety of different symptoms that a patient can have that are all connected to the thyroid. Now, the good news is, is that we have drugs for all of these things. The bad news is, is that we have drugs for all these things. So really what we want to do is find out why the thyroid isn't working, what's the underlying mechanism? In case you're not familiar with these symptoms, which I'm sure most of you are, that's why you're on this webinar. The symptoms can be things like fatigue, increased sensitivity to cold, constipation, dry skin, unexplained weight gain, a puffiness of the face, muscle soreness, elevated blood cholesterol, muscle aches, pain and swelling, and stiffness in the joints, irregular menstrual cycles, thinning of the hair, slow heart rate, depression, anxiety, brain fog, thinning outer eyebrow, cracked heel, and mood swings. So basically everything under the sun. And so it's very, very challenging and frustrating for many patients because you've got a laundry list of things that you're complaining about. And you go to your doctor, and they might not listen to all of these issues because your blood work might come back normal, or they just don't know how to address these things, so they try to treat them and tackle them separately. So you might get a drug for depression or anxiety. You might get another drug, you know, for your mood swings, you might get another drug for your cholesterol, you might get a pain medication for your muscle aches and pain. So there's so many, many different things that your doctor might try to do to address these issues. And it's not that they are poorly intentioned. They're just focused on the wrong thing. Now, some people might experience waves of symptoms. So they might experience, sometimes they have hypothyroid symptoms, which are the ones I just showed you, and other times they might have symptoms of elevated thyroid function. So their symptoms kind of go back and forth. Symptoms of elevated thyroid function can be palpitations, heat intolerance, insomnia, increased bowel movements, fatigue, a fast heart rate, trembling hands, weight loss, muscle weakness, hair loss, warm, moist skin, and a staring gaze. So these are symptoms that can result from too much thyroid hormone production. And that's a whole different condition. Most of you are here to learn about hypothyroidism, but the reason I bring this up is because if your medication is too high, which can also happen as you start getting better. So when I start working with patients as they improve the function of their body and we give their body more of what it needs, what ends up happening is their medication now is too strong for them, so they might start experiencing some of these symptoms. So when you start getting these symptoms, that might be a good time to reevaluate with your doctor your thyroid hormone levels and reevaluate the dosage that you're on. So our goals today is to help you identify the root cause of thyroid disease, how to heal and repair with lifestyle, and then really, we're going to talk about why a personalized approach is more effective if it isn't obvious enough. So let's first discuss, you know, thyroid hormone pathways and just to help you understand what your doctor is measuring and the limitations of measuring that. So your hypothalamus produces a hormone called trh, which then sends a message to the pituitary gland, which is in your brain. The pituitary then produces something called tsh. So, technically, TSH is not a thyroid hormone. It's thyroid stimulating hormone. The thyroid then makes three hormones, T4, T3, and calcitonin. For today's conversation, we're going to talk about T4 and T3. So the thyroid gets the message from the pituitary that we need to make more thyroid hormone. And so it makes T4. 95% of what it makes is T4, which is considered metabolically inactive. It's less metabolically active than T3. T3 is 5% of what the thyroid makes. So let's use a simple analogy. Let's imagine that you're getting paid by your employer $1,000 a week. And instead of writing you a check for $1,000, your employer gives you a $950 check, and $50 they give you in cash. So the check would be represented by T4. The cash would be represented by T3. Now, the significance of that is that cash can be spent right away, which means that you can spend that $50 at a gas station, at a convenience store, at the mall. If you owe your friend some money, you can give it to them. So that cash is metabolically active, whereas the check is inactive. A check you've got to take to a bank and deposit and cash it. So T4 has to go to the liver, the kidney, and the gut and has to get converted into T3. Now, under periods of stress, that red arrow represents something called reverse T3. Under periods of stress, your thyroid will take that T4 and convert it into a metabolically inactive form of T3 called reverse T3. And we'll talk more about that on the next slide. So imagine that you get this check and it's Friday night and the bank is closed. There's nothing that you can do about it. You've got to wait till Monday morning. So that's the scenario that many of you dealing with. Now, what your doctor writes as a prescription is usually for T4. So they're giving you a check, but then they may not be focused on the liver, the kidney, and the gut, which is responsible for converting that hormone into its active form. So it doesn't matter how big of a check I write you, if you can't convert it, it's not going to go to where it needs to go to actually act on the cell nucleus and create a cellular response. Now, the cell nucleus is getting information from the cell membrane. The cell membrane is where the thyroid hormone receptor is. So you've got to have. Not only do you have to have the pituitary gland sending the message, you've then got to have the thyroid gland making the hormone. You've got to then have the liver, the kidney, and the gut converting the hormone. Then you've also got to have thyroid binding globulins, which are proteins that carry the thyroid hormone throughout the bloodstream. And then you've got to have the receiver that receives the information known as the receptor. And then the receptor transmits that signal back to the nucleus, and the nucleus then creates a metabolic response in the cell. There's many steps where the thyroid hormone could not reach its end goal. And so you could have a perfectly functioning thyroid. Okay, you could have a thyroid that produces beautiful amounts of T4 and T3, but you could have high stress that's blocking the conversion. Or you could have a liver, kidney, or gut issue that's blocking the conversion. Or you could have a receptor site defect that's not allowing that. That's not allowing that hormone to be received at the cell membrane. So there's many things that can interfere with normal thyroid function. Now, what this means to you is that you could go and get blood work done, and that blood work can show that your thyroid is working just fine. But what's not being measured is that peripheral conversion and the receptor site of the thyroid hormone on the cell. So some things can be measured and some things we can Assume through lifestyle that there could be problems. For example, chronic inflammation decreases the function of the receptor site. Inflammation is like background noise. It makes it very difficult for our cell receptors to work properly. Also, nutrient deficiencies, which we'll talk about in a moment, can also make that receptor site work less effectively. I really like this image because it helps us understand factors that influence thyroid hormone conversion. So let's assume that your thyroid is making that 95% T4. Now, things that your thyroid needs to make T4, nutrients that it needs are iron, iodine, tyrosine, zinc, selenium, vitamin E, B2, B3, B6, C and D. So these are critical in order for us to make thyroid hormone. Without iron, we can't make thyroid hormone. And so many thyroid patients that I work with, when we test them properly, we find out that they're actually anemic. So if you're anemic, you can't make thyroid hormone if you have inadequate amounts of tyrosine. Tyrosine is also required for stress hormones. So your stress hormones could be hogging the tyrosine. Zinc is a very common depletion. It's one of the most common deficiencies on the planet. So if you lacking these key nutrients, then I can't even expect you to make thyroid hormone. So when I test you and your T4 comes back low and your TSH comes back high, you know, my first question shouldn't be how much medication I'm going to give you. The first question should be why is your thyroid not able to make the hormones? Is it missing certain co factors or nutrients that it needs in order to build that hormone? Other factors can be stress, an infection, fluoride, which is in our drinking water and our toothpaste, toxins like pesticides, mercury, cadmium and lead, and also autoimmune diseases like celiac have a high correlation with thyroid dysfunction. Now that T4, remember, has to get converted into T3 and or reverse T3. Ideally it has to be convert or we want it to convert into T3. Factors that help convert T4 into T3 are selenium and zinc. So there you see zinc again playing a very important role. Factors that increase the conversion of T4 into reverse T3. Now keep in mind that's the inactive form are stress, trauma, a low calorie diet, which many patients try because they're struggling to lose weight, inflammation, which leads to increase in cytokines, toxicity, infections, liver, kidney disorders, and also certain medications can also block or create an increased conversion of T4 into reverse T3. Now the thing with reverse T3 is that it doesn't just mind its own business, it actually blocks the thyroid hormone receptor on the cell membrane. And so it will actually shut off the ability for the receptor site to receive the message from T3. So we get what's called competitive inhibition. Factors that improve the receiver or the receptor on the cell membrane to allow for that thyroid message to be received are vitamin A, exercise and zinc. So you can see that zinc is such an important nutrient, but it's often not discussed. When we think about the thyroid gland, we typically think about iodine. Now, iodine is a very important, important nutrient that our body needs. But you can see that zinc is involved in every single step. And so zinc can be easily tested for either through what's called a spectra cell analysis, or it can be done through a zinc challenge, which is an oral challenge where you put a solution of zinc in your mouth in the office. And that's a very easy way to test if you're deficient in zinc. Zinc is responsible for over 200 other reactions in your body. And you can see in the thyroid, it's responsible for three of the most critical aspects of thyroid hormone production, conversion and receiving the hormone so that the cell gets the signal. Once the cell gets the signal, then it sends a message to the nucleus and the mitochondria to then create a metabolic response. So this is how thyroid hormone conversion takes place. Issues that can affect thyroid hormone and thyroid can lead to thyroid disease are heavy metals, high stress, oral bacterial overgrowth. This is bacteria in the mouth, nutrient deficiencies, free radical damage and deficiencies of antioxidants. Halides. And halides are things like mercury and fluoride digestive disorders, mthfr, which is a defect in a process called methylation, food sensitivities and also autoimmune diseases. There's many things that can lead to poor thyroid function. Poor thyroid, right. So let's talk about some thyroid facts. 90% of hypothyroidism is actually caused by Hashimoto's thyroiditis, which is an autoimmune condition. So your thyroid is actually the victim. It's the victim of the immune system attacking it. And so unfortunately, this is often not tested because there's no drug based solution for the problem. And for your doctor, it doesn't change the treatment plan, it doesn't change how they're going to approach your case. It doesn't change what medication they're going to use, because what they're going to do is they're going to treat Your labs, when your T4 is low, they're just going to give you more T4 in the form of, in the form of Synthroid. If your doctor gives you, you know, a T3 like armor, thyroid, then that's what they're going to do. It doesn't really change their treatment plan necessarily. The immune system requires balance between both arms, and we refer to these as TH1 and TH2. And just to keep things simple today, we'll just leave it at that. There's a major seesaw going on in your life as far as the immune system goes. And th1 and th2 play a very critical role, as does vitamin D, which stabilizes that seesaw. Now what's important to Note is that 80% of your immune system is in your gut. So if we're concerned about an autoimmune condition, then we really have to focus on gut health and the gut microbiome, which is of growing interest to many functional medicine practitioners and forward thinking doctors. And if it is an autoimmune condition, it is important to know that because you can take action, you can actually do something about that. You can fix the gut, you can change what you're eating, you can change the stressors in your life and slow down or stop the damage. Many patients can go into remission from a autoimmune standpoint if we find out what's actually aggravating the immune system, and that's not very difficult to do. Another important thing to note that is if you do have autoimmune disease, if you do have Hashimoto's, then there's a chance that you might have other autoimmune diseases. So I apologize for those of you that might feel nauseous or dizzy or you know, get a headache looking at this image. But this image is a good indicator of whether or not you have something called cerebellar ataxia, and that's an autoimmune disease of your cerebellum. So if you look at this image for a few seconds and it makes you nauseous or makes you dizzy, and then I encourage you to look away. But this is an indication that your cerebellum is being attacked. And even gluten can be a contributor to that as well. So if it makes you dizzy or sick, please look away. But that's an important indicator of cerebellar ataxia and this is caused by immune cells destroying your cerebellum, which obviously is not a good thing. 47% of people with one autoimmune disease typically have another autoimmune disease that is undiagnosed. And what's important to keep in mind with autoimmune diseases is oftentimes there has to be significant damage before these symptoms even show up. For example, someone with Hashimoto's has to have significant damage to the thyroid gland before their symptoms will manifest. Somebody with a pancreatic autoimmunity or a type 1 diabetic, for example, there has to be significant over 90% damage to the organization before that patient experiences symptoms. So we don't always know these things, but with predictive antibody testing, which is something that we do do in our office, we're able to identify if somebody has an underlying autoimmune disease going on that they may not be aware of. And that happens in almost half of the patients that have thyroid disease. So just not to make this too complicated, but where the red X's are is where the immune system can potentially attack the production of thyroid hormone. It can attack the symporter, it can attack thyroglobulin, which is a protein backbone of our thyroid hormone, and it can attack our peroxidation process where iodine is added. So essentially, the immune system comes along and destroys the work of the thyroid. So our thyroid is busy making hormone and the immune system is busy attacking it. And that's, of course, quite unfortunate. So by doing the right testing, we can identify if this process is going on and then identify through other testing what's provoking the immune system to cause this effect. And we're going to talk about that briefly. So one thing that's becoming more popularly known and it's becoming more mainstream, as far as research goes and as far as information goes, is that virtually everyone with autoimmune disease has a leaky gut. Now, leaky gut is also known as intestinal permeability. And we call this the sacred barrier, because the contents of your digestive tract should stay within the digestive tract, unless they're nutrients or food that the body needs to absorb in order for it to carry out its normal functions. But this barrier, think of it like a screen on your window. That screen keeps moisture and oxygen exchanging, but it keeps the bugs out. The bugs are too big to cross that screen to cross that barrier. And so leaky gut is likely the cause of virtually all autoimmune disease. And this was demonstrated by Dr. Alicia Fasano in 2012, and he's a pediatric gastroenterologist. And it was really interesting because he's really probably the first one that really demonstrated this connection between autoimmune disease and leaky gut and made it an acceptable diagnosis. Leaky gut can now be measured. We can actually quantify it. So it's not voodoo or it's not. It's not magic. It's something that we can actually quantify and measure through blood analysis, things that can lead to leaky gut. And, you know, we do a whole one hour workshop on leaky gut. But I'll give you the cliff notes. Stress, dysbiosis, poor diet and medications can all contribute, amongst other things. So identifying where that leaky gut is coming from or what's causing that leaky gut is very, very important. Now, just for demonstration purposes, I hope you can see this. But leaky gut looks something like this. We have a single layer of cells that line our intestinal tract, and this layer of cells creates that barrier. Think of that game Red Rover that you used to play as a child. You have a series of cells basically holding hands, and the proteins that hold them together are called occluded and zonulin proteins. And so what happens is, ideally we want bugs and mold and yeast and undigested food proteins to kind of skim across the top. We don't want those entering into our body. But when that barrier becomes compromised due to some of the things we mentioned, stress, dysbiosis, vitamin deficiencies, what that leads to is these proteins and molecules entering into our bloodstream where they shouldn't be. And now the immune system has to deal with that stress. And the way our immune system deals with stress is through a process called inflammation. So every time the immune system becomes activated, there is an unfortunate inflammatory response because those foreign objects shouldn't be there. The other possibility is you get the actual membrane being broken or the cells being damaged, and that allowing proteins and these molecules to enter into the bloodstream. So in a healthy, functioning gut that has a good, healthy microbiome or good gut balance and healthy digestive function, this barrier remains intact. In people who are stressed out, nutrient depleted, who have celiac disease or other dysfunctions going on, what that leads to is a compromise in this barrier, which then allows things that shouldn't get into our bloodstream to get into our bloodstream. Now, keep in mind that the proteins from our food look very similar to the proteins that are found in, in our own bodies. And that's something that's very critical to understand. What's really interesting is that the protein and gluten looks very similar to the proteins that make up our thyroid gland. So there's a very strong connection between thyroid patients and gluten related disorders. This is the study that I was referencing from Dr. Fasano and the connection between leaky gut and autoimmune disease. And if you go to pubmed.com, which I encourage you to do, and type in leaky gut, you'll see that it's associated with so many chronic illnesses. And so treating and addressing the leaky gut can be so critical to your health. Because if this barrier is compromised, guess what? Not only does it increase your likelihood of having autoimmune thyroid disease and other autoimmune diseases, but it could be the root cause of many, many other disorders. And what we're finding now is that the most common killers these days are actually autoimmune diseases, like heart disease, for example, we now know is an autoimmune disease. Now, the challenge with autoimmune diseases is they each get a different name, so they're all categorized slightly differently. So somebody with Ms. Or somebody with rheumatoid arthritis, or somebody with celiac disease, or somebody with als, they all get categorized differently. So we treat these as separate conditions and we create drugs for these separate conditions. But they're all rooted essentially in the same underlying problem, which is an intestinal barrier that's been compromised. And things that shouldn't be getting into our body are now getting into our body. And unfortunately, our immune system is programmed to kill these invaders through a process of inflammation. And that leads to systemic issues. And this is what basically is the underlying cause of many people's thyroid disorders. Here's an example of a test that we run. The lab that we use is called Cyrex Laboratories. This is the most advanced laboratory test for leaky gut and intestinal permeability. And what we see here is a patient that has a lot of greens, but they've got the occluding zonulin in the red, which indicates that there's still a process going on that's causing these tight junctions to be broken down. And these tight junctions, fragments of them, end up in the bloodstream and the immune system creates a response to them. And that's what we end up seeing. So this person still has some work to do. This person actually had many reds previously, so they're certainly heading in the right direction. But we can see that they're still work to, to do. Now, this is important to understand because if we can quantify something and we can apply a therapy or a treatment for the patient, then what we also do is we're able to measure if that patient is actually better. Because it's hard for you to say, hey, I have a leaky gut, or I have occluded zoning levels that are elevated. So quantifying it helps. This person actually feels really, really well. They actually feel really healthy. But when we saw this, we realized that our work wasn't done. So we were continuing on, healing that gut and uncovering what else we can do to make this person all in the greens. Another thing to look for are food allergens and sensitivities. And the importance of that is that you could be eating something on a daily basis that's contributing to poor gut function or an overactive immune system, for example. This is an actual patient from our office. Again. And what we see is this patient was actually diagnosed with celiac disease disease about six months ago. And the way she was diagnosed is because she has several nutrient deficiencies, particularly iron. She was anemic. So her doctor who had the foresight to actually test her for celiac disease, and it came back positive. And so she started on a gluten free diet, but she was still doing coffee, she was still doing eggs, she loved omelets, she was having a lot of potatoes, she was having gluten free grains. So she was doing sorghum and teff and, and other grains that in this case were just as problematic for her. So she went gluten free and she saw me speak at a conference and wanted to come in and become a patient. So we ran this test on her and what we realized is that, you know, from her subjective reporting that she said, I went gluten free and didn't feel any different, I didn't feel any better. And I told her, I said, pat, well, you're still eating a lot of foods that your immune system is reactive to. Now, the top set of values here, especially dairy, can be cross reactive. And you know, just to spare you the details, what I'll tell you is that your body can mistake dairy for gluten. So you could be on a gluten free diet, think you're doing everything right, but if your body's mistakenly reacting for dairy, then you're going to essentially get the same immune response occurring. So it's important to look and think outside the box a little bit because we really want you to feel well, we want you to feel optimal. And so we look under all the rocks and all the stones and dig through the dirt to find out how we can do that. So as this patient's removed these foods from her diet, guess what? She's feeling a lot better. And now she realizes that going gluten free just wasn't enough for her, and it might not be enough for other people to play it safe. What we encourage patients to do is, and what you might want to try to do in the meantime until you get tested, is to go dairy and grain free. And that includes, you know, gluten free grains. And you can also cut out other starches like rice and potato, and other allergens like egg and corn. So these can be problematic for some people, and you may not even know it without testing. It can take you a long time. But you can try a reintroduction diet, which takes a little bit longer, and it's a little bit more difficult to figure out. So one thing I always want to interject with my patients is that I believe that you were born with the keys to a Ferrari, but the problem is nobody's taught you how to drive it. And so the challenge always is, how do we get you to become a better driver when it comes to your health? How do we get you to understand the rules of the road so that you don't make mistakes, so that you can actually be as healthy as possible and avoid or eliminate having to deal with many, many chronic illnesses like thyroid disease? There's a whole new field of study called epigenetics. And if you haven't read the book the Biology of Belief by Bruce Lipton, I highly encourage you to do that. And what he discusses in that book is very, very powerful and very important for us to remember, and I remind my patients of this all the time, that our genetics are hardwired, but our epigenetics are basically our genetics interacting with our environment. So our environment is what dictates gene expression. Think of it this way, if you go on a vacation, you always feel better. Now, I didn't change your genetics one bit, but what I did do is I changed your environment. And by changing your environment, I sent a different set of messages to your genes, and your genes responded accordingly. So if I put you in an environment where you're not eating healthy foods, where you're under immense amounts of stress, where you're not getting enough sleep, where you're exposed to electromagnetic frequencies on a regular basis, I'm sending your genetics a very different message than sending you away on vacation, where your stress is much lower, you're probably walking a lot more, you're sleeping and resting appropriately, that's a very, very different set of messaging that's being sent to Your body. Now, your genes are very, very valuable because of this adaptive ability that they have. They're not hardwired to respond a certain way. They respond to the environment in. In a very intricate way. So the three things that we know affect our genetic expression in a very profound way are diet, exercise, and stress. So, of course, if I change what you eat, I'm going to send a different message to your genetics. This is why eating processed foods is so toxic to your body, because it sends your DNA a very different message than eating whole foods, which your body's programmed to digest, assimilate, and interact with. Exercise also stimulates genes. Over 500 different beneficial genes are. Are stimulated by exercise alone. And even if it's walking, you don't have to have a rigorous exercise routine and Jillian Michael yelling at you. It doesn't have to be that way. I think exercise can be anything that you enjoy doing that requires a physical activity. So whether it's something like rowing, whether it's just going for a walk with your dog or your children, whether it's climbing a rope, whether it's going to the gym, whatever it might be. Find something that keeps you active, that you enjoy doing, that you look forward to doing if you hate exercising, or then find something else. You know, I think that the idea of not looking forward to exercise and not enjoying it, I think, creates a lot of issues for people. So find something you enjoy doing and realize that when you do something you enjoy doing, that also lowers your stress. So what I find for a lot of people is that exercise can create more stress in their life because they're always worried about how much they're exercising. And I think that we've kind of been conditioned to think that we have to exercise a ridiculous amount in order to stay fit. And that's absolutely not true. The guidelines that the government sets out is that you have to engage in rigorous exercise for. For six to seven hours a week. And that's just absolutely ridiculous. I think if you have the right type of exercise and the efficiency of exercise and the right diet and the right stress levels, you can stay fit without having to spend a lot of hours in the gym or staying, you know, in a high state of intensity when it comes to exercise. A lot of thyroid patients have a difficult time with intense exercise because they might feel worse afterwards. And we're going to talk about why in a second. The other main component, the thing that will kill you every time, is chronic stress. And this is something that is often overlooked. And, you know, when you go to Your doctor and your doctor says, you know, hey, Julie, it's just stress. Well, it's not just stress, it is stress. But stress is a huge player when it comes to your thyroid hormone and how it regulates the other aspects of healing and repair in your body. So through Bruce Lipton's work, he identified that about 75, a minimum of 75% of your health outcomes are based on how we control and regulate our epigenetics. And so our diet, our exercise, and our stress levels played such a critical role in the function of our entire health ecosystem. Let's briefly talk about stress. Stress is one of the most common causes of fatigue along with suboptimal thyroid function. So the adrenals play a very critical role. And if you're not familiar with adrenal fatigue, you can visit our website and we've got some great information about it. There are many common symptoms amongst thyroid and adrenal related issues. So an adrenaline dysfunction or adrenal burnout can very, can be very similar or mirror thyroid disorders. And I've never met a single thyroid patient that didn't have an adrenal disorder going on at the same time. So the two really go hand in hand. They're part of the same hypothalamic pituitary axis. And it's rare not to have adrenal issues, as I mentioned, in parallel with thyroid disease. So it's important to differentiate the two and to recognize the similarities and, and the differences. And proper testing can rule out the adrenals and understand their role in thyroid hormone production and conversion. This is one of my favorite charts. And I know it's probably hard to see on your screen, but all of our goals when it comes to health are basically on the right hand side, which is the parasympathetic division. The parasympathetic side of our autonomic nervous system is what controls all of our healing mechanisms. So our digestive system, our reproductive organs, our lungs, our heart, our saliva production, our brain, all rely on our body being in a state of relaxation, in a state of calm. That's when healing takes place. But most of us live our lives in the sympathetic side of the equation. The sympathetic side of the equation is when we're under stress. So let's talk about that for a second, because you can't live on the sympathetic side and expect parasympathetic results. Our sympathetic side is known as the fight or flight response, or the fight or flight division. And this is a very, very highly adapted, intelligent survival response. So imagine a lion walks into your room, or imagine you have a deadline that you've got to meet, or imagine you find out, you know, some stressful news. There's a series of events that take place that are highly calculated and coordinated to keep you alive. So if a lion's chasing you, let's talk that through. Blood flow is going to go from your cerebral cortex where intelligent thinking takes place, and it's going to go to your hind brain where you become more reflexive. This is more a reptilian brain. This is why under stress, people do and say things that they wouldn't normally say. Our saliva production decreases because chances are, if a lion's chasing, you're not going to be eating the this very moment. So our saliva production decreases. These are people have a chronically dry mouth and are always thirsty. Our pupils will tend to dilate because we need more information coming to the brain. And that makes perfect sense. But these are people that might be sensitive to light. They walk out and they always need sunglasses to, you know, because it's always bright for them. Our airways relax and our breathing increases. We tend to hyperventilate, if you will. Our heart rate increases because our body assumes that we're going to be running away or fighting this lion. So we need this increased blood pressure and increase heart rate to send more blood to the arms and legs. The digestive system shuts off because again, you're not going to be eating if a Lion's chasing you. 30% of your daily calorie expenditure is devoted towards digestion. So if I want to save energy and devote that energy towards escaping the lion, I'm going to turn the digestive system off. That's a really quick and effective way for me to free up some energy. The adrenal glands pump out cortisol and catecholamines and also the kidneys. The kidneys will become dysfunctional, of course the bladder will relax. And this is why people will pee their pants under extreme stress. Children will do this. You'll see this often. And then the reproductive organs shut off, because having sex and reproducing is probably not the smartest thing to do if a lion's chasing you. So you can see that many of these issues, such as high blood pressure, high blood sugar, decreased digestive function, increased heart rate, poor sleep patterns, sensitivity to light, poor reproductive function, all of these things are associated with chronic stress. Now, these are highly intelligent. This is a highly intelligent response under the right circumstances. But if that lion is constantly chasing you, it's going to be a problem now what's significant about this with relationship to the thyroid is that your thyroid takes about six minutes to make energy. Your adrenals make energy instantly. So under stress, your adrenals actually convert T4 into reverse T3, turning off basically thyroid hormone conversion and also blocking thyroid hormone receptors so that your adrenals can take over this, this highly, highly stressful situation. So we can see functionally functional decreases in thyroid hormone conversion and cell reception when people are under stress. So that's very important to understand that when you go to your doctor's office and you get blood work done, that's just a snapshot, that's just a moment in time. Your thyroid hormones are constantly fluctuating based on the demands and based on the environment that you're in. Now. On the parasympathetic side, when we're in a state of rest and digest and reproduction and repair, this is when we're sleeping or relaxed at home reading a book. This is when all, all of our healing takes place. Our healing is very important. This is why sleep is so important. So when we're healing, our airways tend to constrict, so our breathing becomes a little bit more shallow, our heart rate slows down. We stimulate digestion and gastric secretion. So now our digestive system starts to improve. This is why people who eat under stress generally don't feel well. And that should be the expectation. You shouldn't expect to eat under stress and not feel and feel normal. You should expect to feel that your food is not being digested properly. So people with chronic stress, they produce less stomach acid, they produce less gastric enzymes, their mouth is always dry, and the motility of their gut becomes compromised as well. There's less blood going to the gut for healing and repair to take place. So very, very critical to understand these mechanisms. And also reproductive function is also compromised when we're under stress, so that when we're not under stress, our body is better able to reproduce. So just something to keep in mind, I think this is a very important slide for everyone to understand that your body is, will do whatever it takes to keep you alive. It doesn't care how you feel and it doesn't care how you look. I'm sorry to say that, but it's the truth. Your body only knows how to survive and find balance. And it will do whatever it takes to do that. This is an example of a patient who's a nurse. High stress job, probably. Nurses probably have the most stressful job I know of. And we see many nurses that Come into our practice and you know, she just feels exhausted in the morning. She works strange hours. Night shifts a couple weeks and then day shifts a couple weeks, and, you know, her whole circadian rhythm is thrown off. Circadian rhythm basically means hormones fluctuate throughout the day. And what you see is a flat line. What we want to see is a nice corner cortisol, nice cortisol release in the morning. But we can see hers is depressed and it stays pretty flat throughout the rest of the day. So what we've done for her is we've increased her ability to make cortisol by giving her certain adaptogenic herbs and also certain co factors and also really talked her about reducing stress. Now, when you have this type of stress pattern, then it typically means that you've been under stress for a pretty long period of time. And now your body is basically in a burnout stage. And this can lead to exhaustion. It can lead to many of the symptoms that a patient might have who has thyroid disease as well. And guess what? She does also have thyroid disease. So one of the first things we did is a lifestyle assessment which determined that her stress levels were high. We quantified it, and now we're working on a corrective strategy. Sometimes people need to see the effects of stress until they actually do something about it. And so she's learned an important lesson, which is how to say no. And this can be very critical to the healing process. So let's review some key lifestyle factors on what you can do to improve thyroid health. One is to reduce or eliminate stressors. This is very important because stress is a huge contributor to chronic disease, as I just mentioned earlier, and it also decreases normal thyroid hormone conversion and function. We want to eliminate inflammatory behaviors and, and this could include things like processed foods, smoking, you know, trans fats, you know, fast foods. I mean, most of you know this stuff. You know, when something's inflammatory and when it isn't. We want to increase the intake of fresh, healthy foods, whole foods. We want to increase the intake of plant based fats, natural saturated animal fats, and also the intake of organic meats, grass fed beef, things like that. We want to have a consistent sleep and wake schedule. That's very important because our circadian clock relies on that. Our hormones rely on a consistent sleep and wake schedule. So I tell my patients that you have to follow that schedule throughout the week. So if you wake up early on the weekdays, wake up early on the weekends, it's very important. You want to walk at least five to 10,000 steps and I encourage you to buy a pedometer because it's a good wake up call to see how many steps you're taking per day. And I recommend a Fitbit to my patients because I think it's a great tool. And this is a nice way to kind of track your activity level. Sometimes you're more active than you think you are. Sometimes you're less active than you think you are. So five to 10,000 steps is a good benchmark. Start with five and work your way up to 10 or 15. But the more you move, the better it is for your genetics. And then practice mindfulness and meditation. This is an area that I think a lot of people are lacking in. Mindfulness is being present. Don't let your mind wander. You know, stay focused on what you're doing, whether it's eating, whether it's spending time with your family, whether it's working. Just be mindful of what you're doing and stay focused and be present in the moment. The other thing is meditation. And now this seems impossible. For some people, meditation can be very powerful and very beneficial because it induces a state that promotes healing. It puts us in that parasympathetic division, which is where all that healing and repair takes place. I want you to also surround yourself with positive people. People that encourage you, not people that discourage you. You want to be surrounded by people that are positive, people that, you know are willing to help you and motivate you and hold you accountable. These are people that are going to move your health and yourself, your life in the right direction. This is very important whether you're dealing with thyroid disease or not. I think surrounding yourself with important, with positive people is very critical. I'm very, very, very selective with who I let enter my personal space. And, you know, I think that's really helped me because surrounding yourself with negative people can be very, very taxing and it can be very detrimental to your health. And then you also want to develop a personalized dietary strategy. So work with us or find a doctor that's close to you that can help you identify your food allergens and intolerances and help you develop a strategy that's right for you. What's healthy for me and what my immune system likes might be different than what your immune system likes. And that's why testing can be very critical. And then, most importantly, find the cause, find the underlying mechanisms of what's going on. Now, what I will tell you is that, you know, we only have an hour on this workshop, but there's so Much more to know about thyroid disease. And we put that information into our boot camp program which all of you will be getting. And that'll, that'll be very valuable because you'll be getting a series of emails that talk a little bit more in depth about some of the things we discussed today and some of the things that we didn't have a chance to discuss. But there's so much to know about your thyroid. And what I encourage you to do is find someone that can really help you find the root cause of what's causing the dysfunction. Because I guarantee that it's impossible to have just thyroid disease. Whatever, whatever your symptoms are of thyroid disease, whatever the underlying cause of thyroid disease is, you're actually, that is going to affect other systems in your body. For example, if you have iron deficiency, that's going to affect brain function, that's going to affect thyroid function, that's going to affect oxygenation of your tissue. If you have a zinc deficiency, that's going to affect your immune system, it's going to affect your thyroid, it's going to affect other receptor sites. So zinc plays an important role. So if you find the cause, what you'll learn is that that same underlying mechanism is possibly causing other diseases in your body as well. And that's obviously very unfortunate. So you want to find out the underlying mechanism because you never will just have thyroid disease in isolation. It's not like breaking your finger where that's the only thing that's going on in your life. It's very multifactorial and you have to look at the different layers of what's causing the issue. So the number one question I get in my office is why didn't my doctor tell me any of this? I've been suffering with thyroid disease for 10 years now. They just keep increasing my medication or telling me that nothing is wrong. But they've never told me any of this. They never told me the diet could be a factor. They never told me that my immune system could be a factor. They never told me about vitamin and mineral deficiencies that could be a factor in conversion issues and GI issues. And the answer is, I don't know. I'm still trying to figure that out. Our current healthcare system, I think doctors are very well intentioned. I think they're very intelligent people. But they've been trained in a different paradigm. Their paradigm is what drug can I give this person? And what that leads to is, leads to band aid solutions and it leads to chronic suffering. And it's quite unfortunate. So our goal at the Living Proof Institute and the doctors that we train and work with is to really change that paradigm and to give patients like you an opportunity to experience health. And the only way to experience health is to have healthy lifestyle behaviors and also have sufficiency and remove toxicity. So if we can do that, and we can help you do that, I would love to be part of that part of your life, because I know that that's what's going to get you better. We see it every day. So one thing I will say is that you have to ask yourself what you're looking for. Are you looking for a firefighter that's just going to put out fires and break down doors and smash in windows and spray your house with water and put out the fire, or are you looking for a handyman who's going to prevent that fire from happening in the first place? And I think most people are looking for a combination. You need that fire department in case your house does catch fire. But you don't want that to be the only intervention. You really want to work with somebody who can help you find out how to optimize your health. When you go to a firefighter or if you were to call the fire department and complain about your drafty windows and squeaky doors and leaky pipes and leaky roof, they're going to tell you they can't do anything for you. They're going to tell you everything's fine. Because what they're looking for is a smoke is smoke and a fire. And so that's very important to understand that a functional medicine practitioner is not looking. They're going to understand that there is a fire or there is smoke, but they're looking for the underlying cause at the same time. So it's good to have a team of practitioners to work with. I don't replace your family practitioner or your endocrinologist, but what I do is I compliment what he or she does. I do things and I ask questions that they're not going to ask you. I provide interventions that they're not going to provide to you because that's just not what they're trained in doing. That doesn't make them bad people. It just means that you need to find someone who's going to complement your drug based strategy with lifestyle and also functional medicine. So in our practice, we actually offer a five part treatment plan. It starts with personal responsibility, which is the first step. You have to want to get better and know that there is a solution for you. Reducing inflammation, stress and oxidation. And then Also orchestrating system wide balance, which is very important. We don't want to just fix one system and ignore the other systems. We also want to get rid of pathogens and allergens, you know, foods, molds, yeast, things like that, that can be problematic in your gut or in your environment. And then we also want to do functional testing because that provides us with objectives, data points, so that we know what we're doing is working, or we know what foods to eliminate or toxins to eliminate from your diet, or what nutrients we need to give you more of in order to get your body balanced again. So really a smarter approach to your health looks like this. It starts with a thorough history and assessment, a customized dietary strategy, lifestyle education so you know what to do when you leave the office, strategic checkpoints so we can make sure that you're moving in the right direction, and online education tools for you to educate yourself and empower yourself with information. What we give our patients throughout our programs is direct access to us, so they can call us, email us, text us as much as they need to. We provide a personalized solution for them instead of just providing a cookie cutter approach. And lifestyle education is a big part of our consultations because that's where we can get the most return on their investment. If we change what they're doing, if we change their behavior patterns, and we change the questions that a patient asks, then guess what? All of their health parameters start to improve, not just their thyroid health. So I want to remind you that you can never just have a thyroid problem. You're always going to have other issues going on that are causing that thyroid problem and also causing other systems in your body not to function as well. So in our programs, what we include is a thorough consultation, a case review, a personalized program binder, which is about 150 pages of curriculum that our patients go through. A medication review, if you're on multiple medications, a functional nutrition consultation, which means we actually test you for food allergies and sensitivities and then help you develop a customized meal plan and a customized supplement regimen based on what your needs are. I can actually do blood and urine testing on you and determine exactly what your vitamin, mineral and essential fat deficiencies are, and then actually compound a formula for you. So it's really neat what we can do these days with our program, and that really makes the pill burden much less. So you can drink a customized Gatorade, if you will, or vitamin water that's based on your individual biochemistry. We also work with patients for a 6 to 12 month period because we realize that you're going to need a coach, you're going to need someone to help you and guide you along the way. It's not going to happen overnight and it's not going to happen if I see you once or twice a year. It really takes a strategy and a coach and a mentor to really make that happen. You also get lifetime access to our web resources and updates. We also have a diet, a blog that has over 800 recipes on it and that's free to our patients. So that's a great resource for them to help them create a healthy diet strategy. And then we do workshops and you also get direct access to us via email, text and phone. So if you have simple questions, you don't necessarily have to wait two weeks for your appointment. You can ask us a question immediately and we can get back to you within the same day, if not the same hour. And then we also have a patient library and audiobooks that our patients have access to so that you can educate yourself with the resources that we provide as well. So really what we do is we don't compete with your medical doctor. None of these things are being provided to you. What we do is a completely. We offer a completely unique strategy to getting you better. The benefit of this is not only does your thyroid health improve, but other conditions that are lurking around the corner start to disappear as well. Your health improves, which is really what our main focus is. A healthy person does not have thyroid disease. So let's make you a healthy person instead of making you, instead of just treating the tip of the iceberg, which is the thyroid disease disease. Other conditions that our office can address are things like ADD and adhd, adrenal fatigue, brain health disorders, chronic cancer recovery, chronic fatigue, Crohn's disease, psoriasis, you name it. If you walk, if you have a heartbeat, we can help you get healthier. And that's because our approach is so unique. Our approach is to get you healthy and move you in the right direction. And using functional medicine and the lab testing we use, it's very easy for us to do that and move you in the right direction. In fact, our program is so effective, we give you a money back guarantee. So the next thing I want to talk about is, you know, I want to thank you for attending. Many of you stuck around and I really appreciate that. You could have been anywhere else, but you were here today. So I'm grateful for that. So any of you that schedule an appointment today, I want you to know that we will offer you a 50% off your first appointment. Normally it's 99. We'll sit down with you for an hour for only $49 and review your case. And, and it's basically a thyroid discovery session where we can uncover how we can help you if we can help you, and if we can't, we can at least point you in the right direction so you really have nothing to lose. And by doing that, you'll get so much insight into how you can move in the right direction and get as healthy as possible. So I want to offer, offer that to each and every one of you. The other gift I'm going to give you is if you're not in our thyroid education program. I actually have created a 20 email series of videos and content for thyroid patients. So you can learn this through a series of drip emails which will help you put the whole puzzle together and help you understand how the thyroid works, how it breaks down, and what you can do to correct it. So we put that together for you as well, and we'll put you into that program, and that's absolutely free for you. So what I'm going to do now is going to open up to questions, but I did want to leave this up here. So to schedule an appointment, you can con. You can go to the website www.living proof appt.com if you have questions offline you want to ask me, you can email me at drpatel become proof.com you can visit our website, our practice website at the living proofinstitute.com you can visit our Facebook page and add us@facebook.com become proof or facebook.com thyroidbootcamp and you can add me on twittercomeproof.com so at this point, I'd like to open up to questions and see if we can help you answer some of these questions. And I might not know all the answers, but I'll do my best. Okay, so one question was, how do you stay positive when your husbands and kids are not? Good question. You know, what I, what I tell people is that in the darkest room, even the slightest flicker of light is very welcome. So it's important for you to stay positive and for you to, you know, sometimes it's not even about being positive in that environment. Sometimes you just need to get out and be in a positive environment and kill them with kindness, kill them with love, and maybe even find out why they're not happy, why they're upset. Because if they're, if their mindset is very negative, then guess what it's going to create a negative energy and vibration in that entire space, which is not only bad for your health, but it's also bad for their health as well. Well, and then let's see, what is the difference between Synthroid and Armour? So the main difference between Synthroid and armor. Synthroid is essentially T4, which is the inactive form of thyroid hormone and armor is T3. So it's extracted from pigs and it's the active form of thyroid hormone. So they, sometimes you can use both together, depending on the patient, depending on, depending on the doctor. And then sometimes one might, one might just be put on armor on its own. So it depends on what your doctor's, essentially what your doctor's goals are. And then Cindy, is there a list of tests you can give to your doctor? Yes, there is. That'll actually be in the email campaign. So that'll be sent to you. I think it's the second or third email. But if you send me an email, I can certainly send you that list of test that your doctor should be running on you to determine if you have the Hashimoto's or not or if you have excessive reverse T3 or poor conversion of T4 into T3. Okay, does anyone else have any questions, any comments, any feedback for me? Cindy, I will answer. I will certainly send you an email with that question. Steve, is there a way to get off Armor now? You know, it depends on why you're on it. So if somebody's had their thyroid removed, then that's obviously something that, that can be an issue. If, if you have a thyroid, then it's something to look into. A lot of times when you're on medications for a really long period of time, depending on what the underlying cause is, it might be difficult to get you off the medication. Now what I always encounter with patients is that they're not opposed to taking the medication. If you, all you had to do was take a tiny pill and you felt great, then I don't think you'd be opposed to that. Thyroid medication is actually quite safe. The problem with thyroid medication is that it's very difficult to dose. And 90% of people who have an issue with their thyroid is actually autoimmune. So the thyroid is actually the victim. So it's first important, Steve, to identify what the actual problem is. And the other question, Beverly? Yes, we do offer, I work with patients internationally, but I do have, we do have an office in Cincinnati as well. So there's really no issue. We can work with anyone in North America. That's not a problem. And then, Corinne, yes, this will be available. It'll be emailed to everyone. The recording will be sent to everyone. So you'll be able to watch it when. When you log off here. We'll be sending it probably in the next couple days or so. Any other question? Okay. Did you guys find this helpful? Thank you, Chris. Thank you, Steve. And so if there's no more questions, I'm going to take off, go home to my lovely wife and son. And you can always access me, and you can always ask questions through email if you choose to. My email is listed there. Beverly, you don't have to fly to Cincinnati to get tested. We can actually ship the test requisitions to you. So anywhere in the United States we can. We can test you. That shouldn't be a problem. Cindy. I don't have an office in Long island, but I do have a doctor on Staten island that I train and coach, so he might be able to help you as well. And if he can't, then I can work with you remotely if we need to. But we can certainly help you find someone close to you if you're looking for someone that's. That's local to you. Okay. Well, thank you so much for spending this hour with me. I look forward to hearing questions that you might have. You can certainly email me personally and have a blessed evening and make the most of it. Thank you.