98% of Women on Thyroid Medication Aren't on the Right One

88% of us are metabolically unhealthy, and 1 in 8 women, they'll develop a thyroid condition. And most doctors, they run just one test and they tell you everything is fine, and then they send you home. Meanwhile, you're gaining weight, you're losing your hair, you're wondering where your energy went. The Thyroid Fixer is back today, and we're going to go where we have never gone before. So, you know, I love this woman, Amy Horniman. She's one of my best friends. She's been on the show multiple times, and every single time my audience says, this This was the episode I needed. I needed to hear from Dr. Amy Hornaman, the Thyroid Fixer. She is one of the leading voices when it comes to thyroid and hormone optimization. She herself saw 7 doctors before she was properly diagnosed. She was at one time a competitive figure athlete who had gained 20 pounds despite eating super crazy strict and working out super hard. She was told everything was normal. Sound familiar? Since she was last here, she's been developing something she calls Thyropause, We're going to talk a lot about that today. And she has brand new data on what GLP medications are doing to our thyroid. And you're going to want to hear this. And she's about to blow your mind with the thyroid hormone called T2 that nobody else is talking about. We're going to go deep today. Dr. Amy, thank you for being here today.

Hi, Natalie. You know I love you and I love your audience. So this is always good. It's always a good conversation.

So y'all, I met Amy, Dr. Amy. It's funny calling you Dr. Amy because you're just Amy to me.

I know, I'm just Amy to you.

Amy to me. But I met Amy at a meeting, like, gosh, it was like 2 years ago. Is it almost our 2-year anniversary? Maybe a little longer.

2, 3, I don't even know now.

2 or 3 years ago. I remember meeting you and we— it was one of those instant connections. I didn't know or care anything about thyroid at the time, but we just became instant friends. And as friends do, we were talking about all things medical, all the different things. We're both in the health space. And I happened to mention my thought process around thyroid, and I was completely wrong. Like, she was like, "Where in the heck did you learn this?" And I, I consider myself pretty educated when it came to hormones and thyroid, and everything I shared with her, she's like, "I don't know who or what taught you that, but let me explain why that is completely wrong." So she really changed my thinking around thyroid and things I'd been sharing with my audience and, and women, and we're going to dive deep into that today. And I want to start first where I know the biggest question is for women is the actual thyroid panel. Most women go to the doctor, they get checked, and they're looking at one marker, TSH. What's going on there? Why are they only checking for that? And what happens when we do that?

So, the reason why they're only checking for TSH is because it is standard of care. That is what doctors learn in med school. And I talk about this in the book and I joke about it all the time, but yet it's kind of true, which is scary. You can walk into your doctor and say, hey, doc, I have all of these symptoms. I'm gaining weight, I'm losing hair, I'm constipated, I'm tired, all the things. And you will get a test for TSH. If that is elevated outside of that standard lab value range, which I'll go into, then you get T4 medication, you get a pat on the back, send you out the door, say, good luck, Natalie, we'll test you again in 6 months. And meanwhile, you're leaving going like, well, wait, 6 months? But no, I just— I gained 20 pounds. Like, in 6 months, I'm going to be like 40 pounds overweight. What are you talking about? And that is standard of care. This, this, this, done. The problem is that when we're testing TSH, TSH is a brain hormone, first of all. It's not even a thyroid hormone. So, it's released by your pituitary gland. And what it does is it nudges the thyroid. It like pokes the thyroid to say, "Hey, you gotta wake up. You have to produce more thyroid hormone here. There's not enough in the body." But, the problem is that signal is often wrong. Someone can be in a hypothyroid state and not have enough actual thyroid hormone, but the brain doesn't really pick up on that. It's just a little bit slow. And so, that TSH number is highly inaccurate if we really want to diagnose someone properly. Properly with thyroid disease.

Now, when you say that to many doctors, they will challenge that and say, no, this is what we learn, this is all you need. I myself experienced this. This was one of our first conversations at an endocrinologist when that was all that they looked at and said that's all that mattered. And I said, nope, Dr. Amy said something different, and I didn't really fully understand yet. But why is that? Why are they only looking at that?

Oh girl, that's a million-dollar question right there. You know, all I can go by is Years ago, years ago, I talked to this group of integrative wellness practitioners and they wanted to change over. They were in conventional and they wanted to actually start this integrative wellness practice. So, they brought me in to talk thyroid. So, I'm talking to them about the testing and saying, "Okay, we have to do all of these tests. We can't just do TSH alone." I'm talking to them over here about the treatment and how we need to get out of the T4-only box that I know we'll talk about today. And the one doc raises his hand and literally says, that's all we've learned. So that's the only answer I have is, is literally that's what they're learning in med school. And then there's another layer, insurance. Insurance dictates what doctors can test or not test, because if they run a test for something that they don't have a pill for, like a pill for every ill, if there's not a pill, if there's not a pharmaceutical that they can write when that lab marker is off, either high or low, then they're not getting reimbursed. Insurance doesn't like that. They get like a black checkmark on their little medical form for the insurance company. So there's added pressure for doctors to dictation by the insurance companies as to what they can do and not do.

So, and I've heard this before, that if somebody doesn't have an answer, they don't know how to treat it, they're less likely to run the test because then what are they going to say with the information? I mean, we see this with with heart markers all the time. Like, the ApoA is a big conversation around there. Like, there's not a direct answer, so a lot of times they don't test for it. So, it's like this is not an unheard of conversation. Okay. So, in an ideal world, what should we be testing when we're looking at thyroid?

So then, once we talked, you went and got a free T4, a free T3, reverse T3, and TPO and TGA antibodies. Now, let me back up. I'll go through each one of those.

Yeah.

Free T4, that's the inactive thyroid hormone, but we still want to look at it because your body makes about 80% T4 and that T4 stays almost like in, in dormancy until it converts to T3. So T4 is inactive and it literally has to lose an iodine atom to become T3. So then, we drop down and we test free T3 because I want to know how much active thyroid hormone is unbound in your body ready to get to the cell to do its job. So, when we're looking at the body, every cell in our body has a receptor site on it for thyroid hormone, but specifically for T3, not T4.

So, wait, hold on. Does— the only way that you can have T3 in your body before we even talk supplements is from T4 converting to that? Correct. Okay.

Yeah. So, which is kind of wild, right? Yeah.

But I want to follow the thought process because this might explain why certain medications— so the— so your body naturally has T4 and converts to T3, and then we test T3 to see how well that's working, right?

How much— how much of that active thyroid hormone do you have ready to go, like ready to give you that metabolism and light up your brain and grow your hair and all the things you need? Enough T3 for your body to work. If you don't have enough T3, I mean, even your brain and your heart, your heartbeat, you have to have enough T3 to have a regular heartbeat. Otherwise, we are seeing things like tachycardia, AFib, you know, various issues with the cardiovascular system as well.

Okay. So then, what's reverse T3? Okay.

So, reverse T3 is when T4 doesn't convert well to T3. So, I always use this analogy. T4 is sitting at a crossroads. It has two paths it can choose to go down. We hope that it chooses the path of free T3. That's what we want. But it can go down the path and become reverse T3, which is like your anti-thyroid hormone. And reverse T3, when it's too high, it will block T3 from getting to the cell. So basically it's preventing you from having a metabolism, from growing your hair, from having any kind of brain function or energy whatsoever. So, we always, always, always, every single time you get your labs done, you always want to look at reverse T3, and that tells us how well are you converting that inactive thyroid hormone T4 to the active T3.

Okay. So, now, I see where we're going with this because this is exactly, for example, why your spidey senses come up when someone's not converting T4 to T3 correctly because you're like, "If we support more T4, we're going to— and it's not converting already, now, we're going to push up that reverse T3 and create a bigger problem." Exactly. That's what you had said to me. That was my specific situation. Okay. So, let's keep going and then we'll come back to that TPO antibodies. The other things that you mentioned that we check for.

Yup. So, there's two antibodies that we look for to see if you have Hashimoto's. So, that's the autoimmune form of hypothyroidism. And really, when we look at all low and slow thyroid function, about 95% is autoimmune. It is Hashimoto's. So, when we're testing TPO or thyroid peroxidase, and TG, or thyroglobulin. We look at those antibodies. We want those both at zero, by the way. We want no antibodies whatsoever in your body because if you think of those antibodies as soldiers going out and attacking your thyroid, of course, you don't even want 10. You want zero soldiers attacking your thyroid. So, you wanna test both of those and you wanna test them every time as well. Because antibodies are notorious for coming back as a false negative. So, that's where you'll hear someone go, "Well, my doctor told me like 10 years ago that I didn't have Hashimoto's." I'm like, "So, you've only had your antibodies tested one time in your life?" Like, "Oh, yeah." Like, "Mm, let's retest those because we don't know what happened between 10 years ago and now. In fact, you could have had Hashimoto's 10 years ago and they just came up as a false negative." Got it.

Okay. What else are we needing to test around this?

Yeah. So, really, that's it for the thyroid panel. Now, in a perfect world, we're testing hormones, we're looking at insulin, we're testing your adrenals because all of the systems play with the thyroid or the thyroid really dictates all of the other systems. So, when we're looking at, let's say, sex hormones, we always want to look at the balance because oftentimes, women will have— she'll go into an early menopause, let's say, or an early perimenopause where a woman could be in her 20s and have low progesterone and look like an 80-year-old. A woman could be 32 and have low testosterone like that of a 55-year-old. So, we always want to look at the hormone profile since the thyroid dictates the hormones. We want to see if those are off or not as well.

Okay. So, most women, we have a huge amount of women that once we get in menopause, we start having lower thyroid function. And, we're going to get into what that looks like and what we can do, but this— I want to kind of address the standard of care first. We check TSH, we see that that's low overall. You get prescribed— can you name some of the medications that support T4? What are those medications called that we get prescribed?

You'll get prescribed Levothyroxine, Synthroid, Levoxyl. The higher-tier ones are like Tirosint and Tirosint-Sol, but all of those fall under the T4 category, that inactive thyroid hormone.

Now, if that works for somebody, but what percentage of people does that actually correct it for?

Well, it's funny you ask. So A4M gave out this stat years ago. It was a lecture I was listening to, and, and it really hit me, and I grabbed onto this stat. However, I argue this time as well. So at A4M, the woman's up there, she says, okay, 2% of the population with hypothyroidism does well on— I'm using air quotes for those just listening— does well on T4 only. 98% of us need T4 and T3, or possibly even T3 only.

Which is 98%.

98%. Now I'm going to take it down a notch and I'm going to say it's 100% of us need T4 and T3 only. I've never met a person that is thriving and feeling their absolute best and not gaining weight looking sideways at a brownie on T4 only.

So you think those are pretty much garbage medications? Just— and it's—

they're garbage on their own. So we will use Synthroid, Tirosint. We try to stay away from the generic because the generic T4 has a ton of fillers in it. Like, you couldn't touch it, you're celiac, it has gluten in it. Like, there's no way. So we will still use the brand name like Synthroid or Tirosint, but we'll pair it with T3. And really, when we're— when we're talking about— I know we're going to go deeper into the medication piece, but it's so nuanced. So, it really is about finding that right combination for that individual person.

So, someone like me, when I met you, I was prescribed the generic of whatever that was. So, there's all kinds of problems there. You're saying one, it would have created a real issue because there was gluten in it. That's number one.

I didn't know that.

Number two, it would have pushed up because I already wasn't converting well, it would have pushed up my reverse T3, which would have created a bigger issue. So, some of you listening, that are on those standard thyroid medications, this could be your missing link. This could be that detective piece where you're like, "Wait a minute, no wonder I've been on this medication and I don't feel better." So, then we look at the answer to that. So, let's just say you said some people can use that and something else. What is that something else? Is it added T3? What is it? Yes.

So, then we'll add in T3. So, let's take you for an example. Okay. Let's just say you were loaded down with symptoms because that is kind of the unique thing about your case. Is that you're not overweight because of the way you take care of yourself. You're not overweight. You weren't fatigued. You weren't really losing your hair or anything, constipated, nothing like that. But, let's say that you were and we were looking at your reverse T3 being elevated and we were looking at the fact that your doctor gave you Levo, which like you already said, not good because it has gluten. And, number two, it's going to push up your reverse T3. So, let's just hypothetically say you're like, the rest of your listeners out there who are seeing conventional medicine and they're put on T4 only, you start taking that Levo. I mean, number one, yes, you're going to get a reaction because of the filler. But number two, you're going to eventually say, why am I even taking this? Like, can I get off of this medication? Yeah, it's not even making me feel better. Well, no, of course it's not, because it's pushing up your reverse T3 and there's a good probability that your symptoms are actually going to get worse, meaning you're going to gain more weight, you're going to lose more hair, you're going to become more tired. So, it's not that you don't need thyroid hormone replacement, you need the right one for you. So, what we would do is we would see, "Okay, how much T4 are you on?" Let's say you're on 50 micrograms. We're going to lower that down. We're going to bring that down like 25, maybe even like a 12.5. Then, we're going to add in T3 or liothyronine. And we're gonna slowly add that in and titrate up your dose so that the T3 becomes a higher percentage or a higher ratio to your T4. And what that's gonna do is lower your reverse T3, it'll increase the free T3, that active thyroid hormone, and now your symptoms will start to go away because we're adjusting that thyroid hormone in your body to fit what we're seeing in your labs.

Why even bother with the T4?

That is a great question, and it's one that I get all the time. So with T4, we have to think of it like a savings account. We all like to have some money in our savings and some money in our checking. It just makes us feel good, right? So that if we need to, we can pull money from savings, put it in a checking, and then spend it. That's what T4 and T3 essentially are. T4 is your savings, T3 is your checking. And, T3 acts very quickly in the body. Now, for me, I'm T3 only and it's like I can't have a savings account. I can't have T4 because when I add in T4, I get worse. My reverse T3 goes through the roof immediately. With T4 being in savings, if a person can tolerate even a little bit, that's the perfect scenario. Now, sometimes it's trial and error. Sometimes we just have to put it in and see how your body reacts. Are you gaining weight? Are you going hypo again?

Yes.

Okay, well then we're pulling it out then. Then you just can't tolerate it.

What are all these things like desiccated thyroid? What does all that mean?

So that's another category. So natural desiccated thyroid medication is kind of like the middle category. So we have T4 over here, T3 on the other side, and then that blend in the middle. So NDT medication is 80% T4 and 20% T3. The names of those meds are Armor Thyroid, NP Thyroid, Ren-Thyroid. There used to be a Nature-Throid that got pulled years ago that people loved, or it could even be just a compounded T4 and T3 that your compounding pharmacy makes.

Okay.

These are derived from pigs. So, what we do is we dry out a pig's thyroid gland and encapsulate it. It actually was the OG thyroid medication back in the 1800s. It was the first one ever used. I mean, that's how we treated thyroid was we dried out a pig's thyroid gland and gave you some of the powder. The problem with that is like in your case, if you have someone that already has a conversion issue and they already have an elevated reverse T3, by giving them natural desiccated thyroid medication, you're still giving them 80% T4. You're still going to push up that reverse T3. And a lot of people get hung up on this because there's the word natural in the title. And everybody, I mean, I can't tell you the amount of patients that have come into the practice like, Well, can I just use natural desiccated thyroid? Like, I heard that's the best, and that's what, like, all the functional people are using. And it's like, well, sure, if your reverse T3 wasn't an 18, but since it is, then the answer is no. Because even though there's natural in the title, that is going to make you worse, and you don't want that. Ultimately, you want to reduce or eliminate your symptoms.

What was all the controversy recently with natural desiccated thyroid?

Well, it's still going on, so So we still don't know. So back, it was August of last year, 2025, the FDA released a statement saying that they are investigating whether or not animal-derived products or natural desiccated thyroid medication, since it's derived from a pig, these animal-derived products are safe because technically, even though NDT was the OG thyroid medication, it never went through FDA approval. It's never gone through FDA approval process. So the FDA is coming out and saying, since you never actually got approved with us, we're going to ban this medication in 12 months unless you can somehow go through an approval.

Wow.

Now the hiccup with that is you can't get an FDA approval in 12 months. It takes 24 to 36 months, and they knew that. So there's a lot of controversy, there's a lot of, of backstory with that regarding two guys that were fighting and one wanted to get back at the other, and it's just a mess out there. It is a disaster. And, we still don't know if the government is going to pull natural desiccated thyroid medication or not. I don't think so. I truly believe that 1 or 2 are going to make it through the process or they're going to grandfather them in and give them more time to get through the approval process. But, it's scary when you think that there's something like 2 or 5, it was somewhere in between there, million people are on NDT and they're living their best life. And the government is now going to pull it.

Now, could you still create that through compounding? Because if it's essentially T4 and T3 and an 80/20%, could you still do that through compounding?

It wouldn't be from the pig. It would just be— you would— the compounders would essentially take Synthroid or their version of synthetic T4, which is fine. I mean, there's nothing wrong with, with using T4 and T3 in the synthetic form because I actually call them biosynth, meaning they're biologically identical. To what your body makes. Nothing wrong with that. So, they'll just take those versions of T4 and T3 and combine them, but the compounding pharmacies will not be allowed to use animal-derived.

Wow. Okay. What about T3 sensitivity? So, like for example, me because I happen to be that guinea pig on all things like this, I cannot take T3 even though my numbers, everything made sense. No, you don't convert. You've got to take T3. Amy had me get it like crazy compounded low, like the lowest possible baby dose, 2.5, I think it was.

Yeah.

And I still felt like I was on crack. I'm like, I know, cannot. Why? What is that about? Why do some people have that kind of crazy sensitivity to T3?

Okay, first of all, y'all know Natalie, and you know that she's like a canary in the coal mine, right? So highly sensitive to all things, everything, right? It's kind of rare that someone is that sensitive to 2.5 micrograms of T3, but we do have it. I mean, you're not the first, you're definitely not the first patient I had. So what we'll do there is, number one, we're going to check ferritin. Now, we checked yours. Yours was fine. We always check cortisol levels and, you know, we checked yours. Yours was fine. But sometimes we'll see a correlation there when we start.

Mine's high. I have high cortisol. I have high cortisol.

Do you have high cortisol?

Yeah, like 20 in the morning. It's pretty darn high.

And then does it go into a normal pattern throughout the day?

Well, I would hope so. I haven't tested in a while, but I hope so. I can usually feel it. So it's usually higher in the morning and it trickles. Yeah.

Okay, so that one high marker, not worried about. I don't think that's contributing to it. I think you are just more sensitive, like your whole body is more sensitive to everything. Everything, for sure. So that 2.5 for you actually makes you feel very, very amped up. For most people, it would just be enough to like, like have them open one eyeball in the morning. Definitely.

Most people aren't going to experience what I did with it. Amy's like, are you kidding me? Like when I told her She's like, "That's just Natalie." No, you really are an anomaly.

I will say it's not the norm that people are that sensitive to T3. But, if you are, then that's exactly what we do. We'll compound it at a slow release so that you're just getting tiny microgram amounts pulsed throughout the day instead of one big bolus dose all at one time.

So, I chose, and this is an option too, I chose not to take anything. I'm like, "I don't like how I feel on T3. I don't want to." to increase, make my reverse go up, I'm just not going to take it. And what Amy shared there too is it's not always just our labs, which is we have to really be aware of this. Like, we're not just lab values, it's also how we feel. So, your lab values can say something that somebody's like, "Oh, you've got to be on this," or, "You should be here." But if you are feeling fine, that's the truer gauge.

Yeah. I mean, that's the most important thing right there. It all comes down to how do you feel. And those are 4 words that I tell everybody, "Listen, if your practitioner, whoever you're working with, isn't asking you how you feel and they're just looking at your labs and changing doses from that, no, you got to run because you should always overlay how you feel." So again, you are feeling great, very asymptomatic. There's nothing really going on that we need to double down on and address. But if you were the typical hypothyroid patient where you're gaining weight and losing hair and you're tired all the time, then we do something about it. Then, we would sit down to go back to the drawing board and go, "How can we do this? Let's figure this out." I had a sensitive patient one time that we had her on 2.5 micrograms of T3 slow release for 3 months before we could go up to 5. So, it was just a slow, slow, slow climb, but we eventually got there. Yeah.

And, I think we also have to be careful what clinicians ask us. So, if I'm at an appointment and they say, "Do you feel tired?" Well, sometimes we all do sometimes.

So, we have to—

there's It's normal human life to feel tired and then energized. So, it's what's getting in the way of your life. If you're just like, yeah, you get tired for an hour a day, that is completely normal. That's just how your body works. But, yes, if you cannot function all day long, that's a different story. And, same with the weight gain question. Have you gained weight? Well, yeah, I've been eating ice cream every night for the last 2 weeks, so maybe you have. But, if it's like, no, you've done everything the same and you are, that's a different question. So, I think sometimes the questions prompt us to say yes when, like, you have to, like, really think, like, is this true? Like, am I eating the exact same thing and then this variable changed? Yes, the entire thing. Like, every single person, human, there's an hour during the day that you're tired. Like, it's just— that's just human nature, right? Right.

And then, you know, you have to differentiate. Is it that extreme fatigue?

Yes.

Are you gaining, like, 5 pounds a week? You know that you have to look at it that way, or while you're trying to do everything right, you're still gaining weight.

Yeah.

Totally.

Okay, so let's talk about— you have a term you coined, uh, thyroid pause. What does that mean?

So my definition is when your thyroid gland craps the bed after the age of 40 due to fluctuating hormones. So what that actually means, and you know, we have so many friends in the menopause phase, and, and I love all of them, and I love the fact that we're getting more of a spotlight on women's health, and we're recognizing that, listen, perimenopause and menopause is real. And it sucks for a lot of women and there are answers as to how to get through it, right? That's fantastic. The problem is that we're not talking about thyropause. We're not talking about the thyroid being the master gland that really dictates everything else. And, the fact that if a woman does go into perimenopause and menopause and starts exploring the bioidentical hormone replacement pathway, That's fantastic too, but those hormones are not going to work or work as well unless you're addressing low thyroid function. And you might not even get symptom relief from hormone replacement therapy if your thyroid's in the toilet. So, what ends up happening when we move into perimenopause and menopause? We know that the first hormone that declines is progesterone. That could be in your 30s, that could be in your 40s. I mean, that could be in your 20s if you're having heavy cycles or you have something called— Polycystic ovarian syndrome, progesterone will, will tank. Then that's followed by testosterone. Testosterone usually starts to go down after the age of 40. And then your estradiol or your estrogen will go on this wild roller coaster ride for a while until it just falls off a cliff. And then you're in menopause. That hormonal dance, that hormonal chaos that your body is going through is just enough of a stressor on your body to flip the autoimmune switch for Hashimoto's from the off position to the on position.

Which is what happened to me too, of course. That's what happened to me, of course. You pointed that out. I'm like, great, now that we've added this into the equation. Okay.

Well, yeah, because we'll see that with antibodies and you had antibodies.

Yeah, exactly.

So, autoimmunity, it can lie dormant for years, if not decades. And if you have one autoimmune, you're likely to get another, correct?

So, like celiac or any, any one that you have, you're likely to trigger. And this isn't a doomsday, it's just, it's something we have to pay attention to.

It just is, exactly. I mean, one autoimmune condition always leads to 2 or 3 more unless you catch that early enough and really try to contain it and lower those antibodies and support your immune system.

How do you do that with Hashimoto's?

So, we'll use things like black cumin seed oil, that's in supplemental form, so that's over the counter. Black cumin seed is amazing at lowering antibodies, lowering inflammation. It helps with so many of the symptoms of Hashimoto's as well. Then we'll use a prescription called low-dose naltrexone, LDN, that almost mimics what black cumin seed oil does in that it lowers inflammation and lowers antibodies. So someone that has antibodies in the thousands, I'll double down. I'll use both. I'll use black cumin and low-dose naltrexone. And then we might even use a peptide called thymosin alpha. That actually supports your immune system and it helps to kind of regulate your immune response. I'm even using that right now just to support my immune system for cancer surveillance, just, you know, for searching those mutated cancer cells or circulating tumor cells. I use thymosin alpha for that. And then going gluten-free because gluten-free is not a fad. This is— it's not a fad and it's not just for celiac. This is for all autoimmunity and especially Hashimoto's because when we look at gluten as a molecule, the protein of gluten is called gliadin. And you look at that under a microscope and it actually looks very similar in structure to the thyroid gland. So, if you have Hashimoto's and you have these soldiers that are programmed to think for some reason your thyroid's a bad guy and they go out and attack it just like for you with celiac. Your little soldiers think that the villi in your small intestine are bad guys and they like to go out and just kind of beat them up and flatten them out. Well, same thing with the thyroid, beating up the thyroid. Every single time you eat gluten, those soldiers think that the enemy is coming in. You know, they're on watch too and they're like, "Oh, look, there's something coming into the body that looks like that pesky thyroid gland that we like to go out and attack." So, naturally, let's go to war, guys. And every time a person eats gluten, they are building their army and they're literally launching an attack. So, when your thyroid's attacked, it's not gonna work well.

So, I believe most auto— all autoimmunes actually should be off gluten. Yes. What about dairy? I've felt that about dairy too, but where is dairy connected in Hashimoto's?

Yeah. You know, it's very personalized with dairy. Some autoimmune people are very highly responsive to dairy. I mean, our friend Anna, I mean, we know she avoids dairy like the plague, right? Whereas I can eat organic cheese and organic half-and-half in my coffee and I'm fine. So it's really unique to each individual.

So in my experience with dairy, based on nothing other than my opinion, right? My opinion and, well, and my fat loss community. So just helping women through fat loss and health and nutrition. Is sometimes people just think that dairy is problematic if you have the stomach issues, right? But, but dairy is a little bit greater than that. So you might think you're fine eating dairy, like, yeah, you're not— you don't feel bloated, you don't have issues in your stomach, but it's that inflammation that lingers. So like, I'll— like me as an example, if I have dairy, I feel great.

I don't feel fine.

It's the next day or the day after that I can feel things. So it's— I think dairy is highly inflammatory. And I'm not saying I'm an extreme, like, make Anna and it's a never never. But I think that anyone with autoimmune should be paying attention to that.

Yes, should be paying attention for sure. And just like you said, pay attention to how your body feels the next day or the day after and not just your gut. I'm glad you brought that up. It could be migraines, it could be fatigue, you know, a stuffy head.

It could be fatigue.

It could be any— it could be just weight gain. Yeah, it could be like, hey, all of a sudden the scale went up and what the hell? I'm not eating anything differently.

If my scale goes up, it's always related to dairy. Like, I can trace it back continually. Like, if I'm like, oh, I'm having organic raw milk dairy ice cream, it's got to be good for me.

I was just going to ask you, are you eating real dairy ice cream right now? Yeah.

Oh, I definitely am. I told Amy before we started recording, I said I got on the scale this morning and it was up 5 pounds. And I was kind of kidding around with her, but also I'm like, oh, that's my sign. I'm like, okay. But I also know I've literally been eating ice cream every night. So, to me, dairy reacts very strongly in me in other ways, not in bloating, not in stomachache. So, I just want to point that out to people. So, sometimes there's— it's not about never having certain foods, but it's really important to know how certain things are triggering us so we can dial in. Okay. So, you talked a little bit about how hormones are affecting thyroid, but I want to— we talked about progesterone. Can you bring into the equation estrogen and testosterone? Did these help?

Did they hurt?

Like, what's happening there?

Yes, absolutely. So estrogen, when, you know, we just talked about going on that estradiol-estrogen roller coaster as we transition from perimenopause to menopause, which means that at points in time you're going to be estrogen dominant. And a lot of times you hear women say that, like, okay, I'm estrogen dominant because I'm bloated, I'm retaining water, I'm really weepy. And they can almost tell that estrogen dominant state whether we are low in progesterone and higher in estrogen, or whether we're in true estrogen dominance, or maybe we are taking BHR, especially in the form of oral estrogen, which, by the way, I don't like. But if you're on oral estrogen, listen up. Or even a higher dose of estradiol cream or a patch that can increase something called thyroid— thyroid binding globulin. Or TBG, and that TBG will bind to your free T3, the active thyroid hormone, and it will actually lower it or render it inactive, not able to get to your cell. So, in those individuals, we have to look at, okay, what delivery method of estrogen are you on, or are you estrogen dominant because you don't have enough progesterone? Let's look at the situation, the hormone situation over here. We might have to come over here to the thyroid and increase your T3 dose because you're going on DHRT, but it's important for the practitioner you're working with to know that relationship between hormones and the thyroid because they do play a role. Now, when we're talking about testosterone, testosterone is very protective against autoimmunity. And this is why men get so much less autoimmune than we do because they have abundant testo— even a man who has low T, still has more testosterone than we do. So, he has that layer of protection against autoimmune conditions. It's also very anti-inflammatory. So, when we have our testosterone levels at an optimal level, we're actually able to lower our inflammation and improve our resistance to autoimmunity.

Now, this is a whole other conversation. I don't want to get too off track here, but people will a lot of times ask about amounts. And what is a proper lab read. And I know this is so bio-individual, but is there any kind of little bit of a general you can give perimenopause versus menopause or post-menopause of what you see ideal for people?

For dosing, you mean? For those who are on—

Well, not even just dosing, like number, maybe the numbers that should show up on blood. And I know this is, I want to put the disclaimer, this is super bio-individual. So, where somebody might thrive at a much higher number, But any kind of range you can give to support a little bit, because people really have zero idea. A lot of times women are like, I have no idea, like, where I should be.

Oh yeah, there's definitely some general guidelines. So let's start with progesterone. Progesterone, I love that in the double digits, okay? Like 10, 15, 20. And then it all depends on when we're looking at that number, what delivery method of progesterone is she on, if she's taking progesterone replacement, what time during her cycle, if she is still cycling, when did she test? So we have to look at all of those factors when we're looking at the progesterone. But in general, double digits.

Okay.

Estradiol. So not total estrogen. Remember, estrogen is broken up into 3 different estrogens. We have estradiol, estrone, and estriol. So we're really looking at that estradiol number when we're looking at menopause and symptoms and symptom relief. We want that estradiol to be above 50 nanograms per deciliter. 5-0. Now, that's just baseline.

That's pretty low. Yeah, that's pretty low because we hear some people say hundreds, 200. So you're saying just— we just want it about 50.

Bottom of the barrel is 50. Like, until you crest 50 nanograms per deciliter, you don't have bone, brain, breast, and heart protection. Got it. So once you crest 50, you at least have that layer of protection, but you might not have symptom relief yet. I would say most women do their best 80 to like 150.

Oh, yeah.

With their estradiol. And then testosterone, same number as estradiol, 50, 5-0 nanograms per deciliter. That's where, as long as it's above a 50, that's where women will feel their best. Now, to your point, you'll have the random woman that's like, I want mine at 200. And meanwhile, you and I are growing like a beard and breaking out like a 14-year-old.

That would not work.

At 200, like, I couldn't handle that. But Yeah, above a 50, right around 70 is where I find—

What about the free conversation though? Because you can have a total testosterone but be showing nothing on free. Like, what's the proper range for free? Exactly.

So for free testosterone, we want that in the upper half of the range. That free testosterone lab value varies from lab to lab. So instead of giving a definitive number, I just tell women, look at the range, cut it in half, and you want to be at least halfway or above.

Okay, so give an example. So like if someone— because depending on the lab, like it might say 0.8, and we don't— I don't know, people are like, oh, that's super low, but maybe it's not.

I don't know, maybe it's not. Yeah, so you have to look at that lab value range. I'm trying to remember LabCorp's off the top of my head. I want to say like, let's just use like a—

you can even just make one up for an example. So we—

yeah, I'm thinking LabCorp's like a, like a 2 to a 6. Okay, so let's go 2 to 6. Then you want to be right around, I would say, like you want to be around a 4 or 5 for the free.

So, if your free is super low, like really low, but you have a higher T, that typically means your hormones are bound. So, you probably have a high SHBG, sex hormone binding globulin.

Thank you.

Did I say that right?

Okay. You did.

So, if you have that happening, do you suggest things like boron to help free it?

Yes. So then to your point, we look at the free, and if that's low but the total is good, then we drop down and we look at SHBG, sex hormone binding globulin. We want that below a, below a 60. I always have to get my number. It's like 80 to 100 is vitamin D, 60 to 80 is SHBG. So we want SHBG between a 60 and an 80. And if it's too high, then yeah, it's going to be binding. To your free testosterone. So, that's where you're going to throw in boron to try to help lower it. Saw palmetto helps lower it. What else does— Tongkat Ali helps to lower it.

Okay. So, there's ways to lower it. So, when we hear testosterone total numbers, the reason I wanted to bring that up is it's also very bio-individual. Like, you might be listening and you're like, "Well, gosh, my total is 200, but I don't feel anything because your free is super low." So, it's the free number that actually is what's making those things like we say, growing hair, growing a beard. If your free gets too high, as I would imagine, that's the bigger problem. Is that accurate?

Well, and then it comes down to another marker called dihydrotestosterone.

What is that?

So DHT, you know, when you hear men have like the receding hairline. Yeah, that's because they have too much dihydrotestosterone. Their body is taking their own testosterone, or if they're on TRT, and it's converting, it's pushing it down something called the 5-alpha reductase pathway, which is an enzyme pathway that takes your testosterone and converts it to dihydrotestosterone. Now, DHT is not inherently bad. It's just if we have too much of it, that's where we get the androgenic side effects. By androgenic, I mean loss of hair. On women, it's gonna be more diffuse, like the crown of the head. It's not necessarily gonna be a receding hairline. Although, and I remember this, you had a great video a while ago where you were talking about how our foreheads become a five head.

Yeah, I said our foreheads become a five head in menopause. They do. Yours is not, mine has definitely.

It's becoming. Oh, mine's grown. Mine has grown.

You're watching on video, like, seriously, y'all, listen, go look at pictures of yourself in your 20s. Our hairline was more up here.

It was. I know.

What the heck? It's just another plus.

And I think that is a little bit of DHT, although it's not, you know, like I said, for women, DHT is more diffuse. But we do want to test it and look at your DHT level because that also is going to determine your testosterone dose. If we're going to do—

got it—

BHRT with testosterone, we're not going to start really high if you already have an elevated DHT. And let's say you're already dealing with dark facial hair or adult acne or something. We don't want to push that further down the road.

I want to get back to thyroid for a minute. We were talking— we talked about, um, T3, T4. We did not talk about T1 and T2.

What are those? Two other thyroid hormones. T1 is inactive, so we can actually set it aside.

Okay.

T2 is actually very, very active. So T2 and T3 are similar in that they will both cause fat loss, they'll both help with metabolism, they both help with energy levels. They're very active thyroid hormones that work on the cell.

Okay.

T2 is a little bit different in that it gets more into the mitochondria of the cell and it works inside the cell. And T2 doesn't have a feedback loop. So, you know how all hormones have this feedback loop to your brain that essentially shuts down your own production. Now, listen, if you're low anyways, then we don't care about shutting down your own production because your own production sucks. It's not doing a great job. But with the thyroid, we don't want to put someone on T3 who, let's say, doesn't need it because it's going to actually cause them to become hypothyroid. It's going to shut down their thyroid production. T2 is a little bit different. So if you do have somebody like— again, I'm going to go back to you. Let's say you had weight to lose, but we just couldn't get the T3 in. Like, there's just— your body is just not accepting it. It's reacting. I would use T2 instead because it's going to increase your metabolism. It's going to help with your energy, but it's not going to have that negative feedback loop on your thyroid that's going to make you worse if you take it. The other thing is it's not going to burn muscle. So we know with T3 that it's going to burn muscle and fat. Now, when you need it, you need it and you just don't care and you do things to offset that, that muscle burn, or you use as low of a dose as possible to get you optimized, but don't go higher. With T2, it leaves muscle alone, and T2 is in supplemental form, not in prescription medication form. So you actually don't have to beg your doctor for it, which is—

and you actually have a supplement with this too.

I do. So I go into this in the book, into the whole story of how T2 and Thyroid Fixer was, was basically born because I had been studying T2 for about 20 years. It has 30 years of research.

Wow.

And I was using it in practice before we could prescribe to all 50 states. I was just one-on-one locally. So I'd be meeting with these women and they're stuck on T4 only, which we already talked about wasn't working. They were struggling with weight loss. And so, I would give them T2, but it was in this BroScience formula that had like an angry gorilla on the front. And so, I'm trying to tell like a 45-year-old perimenopausal woman to buy this angry gorilla-containing supplement. And she was like looking at me like I was crazy. But it was working. It was working. Like they were actually busting through that plateau. Despite being on T4 only, despite their reverse T3 being high. And what T2 does is it also helps with that conversion of T4 to T3.

So, what about iodine?

Hmm.

Yes.

Controversial. Controversial. You know, iodine, I would say in our functional community, it's split. It's split like 50/50, 60/40, pro-iodine, con-iodine. I'm in the pro camp. I love iodine for everybody. You just have to find the right dose and not go too high too quickly.

Okay. What is the right dose?

It— you just find it yourself. So I, I love starting people on a liquid. Okay, number one, you got to start on liquid iodine so you can slowly titrate up one drop at a time.

Literally drops, not a dropper, drops.

It's just a— yep, one drop, like literally one drop in a small amount of water. That's where you start, and then you'll go to two drops the next day, and then three drops the next day. The whole time you're gonna be paying attention to your body. The day that you go one drop too high for your body You're just going to feel like you drank 5 Red Bulls. Like you're just going to be like, "Whoa, okay, what's going on? I'm a little bit shaky here." It's okay. It'll go away.

So, it's that sensitive drop-wise? Yes.

Oh, yeah.

Yeah.

Yeah. Even non-sensitive people will be sensitive to iodine. Like they'll know it.

So, people that are against iodine, what's their reasoning?

You know, I really think that iodine got that bad reputation. When practitioners were using too high of a dose. So, there were practitioners out there that would start people on 50 milligrams. So, for instance, when we start titrating you up with iodine, I'm talking about like 1 milligram and then going to 2 milligrams and then maybe making your way up to 6, maybe 12 milligrams. You know, for me, I take in like 25 milligrams. Well, you're not normal.

Like, Amy can have 50 Red Bulls and I can't even have a sip. So, we're just not normal. Yeah, we're different. We have different DNA.

But, I would say that the practitioners that were out there before, they were starting people on 50 right out of the gate.

Wow.

They weren't even getting them warmed up or testing their body with iodine first. They were just starting them right on a higher dose. Well, what can happen is that person can actually go hyperthyroid or have a thyroid storm where their thyroid dumps a bunch of thyroid hormone, and then they feel icky and sticky. It can cause heart palpitations, AFib, tachycardia. So that's not good. And that's really where it got the bad reputation. When it's used properly, it is essential because it will lower your reverse T3. It helps your body detoxify from fluoride, chlorine, and bromide, which we're exposed to every single day.

So I have droppers, like mineral droppers of like selenium, like all the different minerals, iodine. I just drop like a couple drops in my water every single morning, and I just Just mix it all together and do it.

I'm going to go read the bottle after.

I want to see how much that actually is, but I didn't understand that literally you're talking about little drops, not dropperfuls. So, we have to pay attention to that. Yeah.

You'll have to send me a picture of the iodine that you have and then I'll tell you because I want to look at the dosing.

Talk about GLPs right now and what does this have to do with thyroid? GLPs, yes.

So, I have an entire chapter in the book on GLPs and I know you and I have been going back and forth. Honestly, I think in our entire history, I don't think there has ever been a medication out that is such a Jekyll and Hyde. Yeah. Medication. Like, I mean, just the extreme. So on the one hand, it's miraculous for these type 2 diabetics that had no answer, that are walking around in this— for sure— state, elevated A1C. They can't lose the weight. We know obesity is, is detrimental. When we're talking all-cause mortality. I mean, all diseases stem from obesity. So, on the one hand, fantastic. On the other hand, like you and I are talking— have been talking about, you have these IG influencers pushing research chemicals because they get a kickback on GLPs. You have celebrities out there with their own commercials for GLP-1s. I mean, like, what are we doing? And then, we have these women that are taking these higher doses, they're losing their muscle, They're losing their hair. They're looking like Skeletor. They look 20 years older than they are with Ozempic face. I mean, it's getting ridiculous. And it's like you said before on one of the podcasts we did together, the heroin chic look is back. That's not what we should be going for. What happened to this muscular, athletic, healthy look that everyone was going for?

So aside from our opinions, because my gosh, we could do 10 hours about our opinions here.

I spun off there.

Is it helping thyroid? Let's start with that.

Sorry. Yeah. I just—

No, no, it's okay. I just don't want to— I love that conversation. I just don't— I think people are going to do what they want to do. And I don't want to share— I've shared my opinion so many times. I'm so not against them. I think there is a great place for them in circumstances, but I don't— People can choose to do what they want to do and how they want to do it. If they want to fuel an eating disorder, That's up to them if they don't want, like, I don't know. What I'm very interested in is how they help. I, there's the data around metabolic syndrome is huge.

Yeah.

The data around reversing type 2, huge. The data around heart disease is amazing. Repairing plaque, like there's so many benefits there with the small tiny microdoses.

Yep.

So I'm curious, is there something with thyroid here? Does it, does it help with that? Both.

It helps and hurts. So in a microdose form, we are seeing an improvement in thyroid function because we're lowering inflammation. And we're actually seeing, and I'm one of them, individuals who truly do a true microdose.

Okay.

Not a microdose that you think is a microdose, but it's actually a real dose. A true microdose.

Yeah.

Well, I was able to lower the amount of T3 that I'm on. Now, like I said earlier, T3 will burn muscle and fat. Well, the last thing I want to do As a 52-year-old woman, it's burn muscle. I'm working hard enough to keep it. So, if I can reduce my T3 and still stay in optimization land, then I'm going to do it. And, microdosing and GLP helps me with that. On the other hand, we are seeing some detrimental effects on the thyroid when it's used inappropriately.

Okay. When you say inappropriate, like they're doing it to cut off their hunger, like what do you— tell me what you mean. Exactly.

They're doing it just to lose hunger. They're not getting in enough calories. They're basically in starvation mode or a caloric deficit. Some people are doing it to do fasting. Yeah. They're like, "Oh, I can do a 20-hour day fast." Totally.

Can you—

I know this is detrimental.

I don't want to get too off topic, but Amy shared recently. So, Amy microdoses. Like, you would microdose, did you say every 10 days approximately, or what is your schedule?

Oh, yeah. 10 days to 2 weeks.

So, 10 days or a few weeks. And she does a true, like a very small, as you can see, like she's super muscular. She definitely eats. I've seen her eat. She eats more than me.

Great.

You're an eater. It's good.

I love food.

Yeah. It's good. She works out. So, not going there with that. She does it more for her autoimmune and all the things. But she accidentally, she had switched brands and she accidentally did like an actual weight loss dose and she killed her appetite for, what did you say, like a week or was it 2 weeks? 2 weeks. 2 weeks. She could not like killed her appetite. But that's not the point. The point of this is she was— well, she was bummed that she did that. And she kept trying to force in protein and whatever. But it was the rebound was— it's kind of comical, but it's not. Can you share what happened and what this taught you about this?

The rebound?

Okay.

So, you know, we hear a lot of talk about how people's appetites are going to come back, and that's how they're gaining the weight and all of that. Well, after those 2 weeks passed and the dose was starting to wear off, my hunger came back like a freaking lion. So I actually calculated that day and I made a video about it. And you're right, it is kind of funny. I ate a container of those little mini donut holes. I ate a stromboli from Sbarro Pizza. Like, horrible. Like, I'd never go there. I ate a stromboli. I ate half of one of those really large bar pretzels.

You had like 500 grams of carbs.

500.

500 grams. She could not stop. But what did that teach you? And what's kind of the lesson and the warning in that, other than you better not mess up your medicine? That, that's— yeah, what was like the bigger thing that I want— we want women to hear from that?

Well, it's the realization that these people that are, are taking a standard dose just to kill their appetite or lose those extra 5 to 10 pounds, they're gonna gain it back. Like, we are gonna have a major problem, and And the reality is we don't really know what's going to happen with these medications. We don't know. They're already gone for the most part from research websites. Like, if you're still seeing GLPs on a— okay, on a research peptide website, I would even question the validity of what's in it because most reputable research peptide sites have gotten rid of them. We don't know what's going to happen with the compounding pharmacies. We do know that Big Pharma is coming down hard and they are trying to be— to basically have a monopoly on the GLPs where you have to get a prescription and you have to pick it up for— from CVS Pharmacy for 2 grand a month. So a lot of people are going to have these meds potentially ripped out of their hands, and then what? And then what when that hunger comes back and you can't control it? What are you gonna do?

I go back— I'm gonna be really honest, I go really back and forth between what's truth and what's not. Part of me believes and wants to believe these are life-changing medications and this is breakthrough science and this is, wow, we're going to find so many uses. This is hugely helpful. A big part of me wants to believe that. Then, there's this skeptical part of me that's like, wait, big pharma always makes so much money. What's this agenda here? Are we trying to get people addicted to them? What else is it going to create? I am split. I don't know why.

Right there with you.

And I'm not going to tell someone which thing, but I think I've got to be open-minded here and go, "I don't know." So, yes, I see and I hope there's all these amazing benefits and it's breakthrough science. And my gosh, in 10 years, there is no such thing as metabolic syndrome or obesity or even cancers. That would be amazing. But I have this skeptical side that like, what else is this creating? And I think back to so many things in our history on a smaller level that— think about nicotine years ago, getting everybody hooked on smoking and then What do we say about that now? Think about— I mean, there's a list of things that this has happened for. So I don't know.

I know. I'm right there with you. I am so torn. Like, we will prescribe them in the practice. That's not a problem. And I actually had a patient the other day. She's like, I heard your podcast because I just recently did one too. Yeah. On the downsides and the dark sides of GLPs, just as like you and I have both done podcasts on the positive. Things, sides of GLPs. And she said to me, she goes, well, what, what should I be doing? And I said, well, you have a legit 30, 40 pounds to lose that it's not coming off despite everything. Like, we even have your thyroid optimized, you're on hormones, you're, you're doing the right diet, you're doing— so it's more concerning for me for you to walk around with those extra 40 pounds. Just like we talked about, obesity is not good for you in any way, shape, or form. So I would rather her use a standard dose. Let's get the weight off and then we will drop you to that microdose for the anti-inflammatory benefits and all the others like, like your liver, like your heart, like your brain, all of that. So in her case, yeah, let's use as low of a standard dose as possible. Like I'm talking even like 2.5 or 5 milligrams of trazepatide, as low of a standard dose as possible. And then let's drop you to the micro. But the concern I think that you and I both have are these people taking 5, 10, 12.5, like they keep going up and their doctor keeps pushing them higher and higher and higher in the dose. They are going to be addicted and they're going to have a really hard time dropping back down.

And is it true, like once you, you can't stay at a certain amount forever? So like, let's just say someone's like, well, I only do 0.75 or whatever. I'm just saying they do like a micro, whatever they're considering a microdose. Can they forever stay at that microdose? Does it stop being effective? Like, I don't understand that either for people.

I don't know that we have the data on the microdosing effectiveness, staying at the same dose. We do know that the standard dosing, you do develop a resistance to it.

Really? So you're going to have to go up. So you're not— even if you're on the lowest weight loss dose, you're going to have to keep going up. So at what point does that stop? Exactly. Yeah, exactly.

One of my best friends back home, she's using a GLP for actual weight loss.

She needs to lose weight.

However, I'm really concerned because, yeah, her doctor keeps bumping her up and it's like now she's at, I think, like a 12.5. And I'm like, please just try to stay there.

Yeah.

What happens if you can't get it?

Like, what's going to happen? It's going to be— everything has a yin and yang. There's going to be a rebound. That's scary. I know. That's scary.

Now, there are other things. I mean, can we use berberine? Can we use like T2 like we talked about? Absolutely. There's going to be other things there and available, probably in supplemental form. That's going to help support your metabolism. In fact, we were using berberine back in the day to lower insulin and A1c before the GLPs came along and it was working really well. So, there still will be answers, but it's not going to be that easy answer.

Lots of things for people to think about there. Okay. I want to look back to thyroid for a minute. I want to give people sort of some marching orders here. Starting with Amy has a new book, The Thyroid Fix. Please go get that book. Obviously, you can see she is genius when it comes to this topic. I don't know a better doctor around thyroid. Like, you always explain it so simply. You're so knowledgeable. I know there's a gazillion books on thyroid, but not like what you teach. So, please get The Thyroid Fix. That's number one.

We'll put a link.

Do you want them to go to a specific link for Thyroid Fix book?

Yeah, they can go to thyroidfixbook.com. That's where you'll see a lot of the bonuses that are tied to buying it from that site. And if you just want to pop over to Amazon, Barnes Noble, Target, wherever books are sold.

So, any bookstore. Okay.

Exactly. Yep.

Okay. So any bookstore, Amazon, you go to her, the link that we put down below. Also, do you guys want to go deeper with Dr. Amy? Because I have done this before with her, but we're going to do it on another level. I love doing live interactive classes where it's kind of like what we're doing here at this podcast, but we do it on Zoom where you're on with us and you can ask questions too. We're going to go way deeper around thyroid. And, that's coming up. So, I'm going to link that below to— or if you're listening and you're driving and you're like, "I just got to remember for later," if you go to midlifeconversations.com/thyroid, it is a free session we're going to do one time, one time only, but we'll be on there live. It'll be similar to this format, but you're going to be able to ask your questions too. And, she's going to go over bigger examples. So, you can literally bring your labs to that so you can be looking as she's teaching, all of it. It's going to be really good. So that's below. I'm also going to link below your product line because I think that's important too. She makes all kinds of products to support thyroid that you don't need prescriptions for. But what do you want for their marching orders? Like, they're like listening, going, wait, some of this is starting to make sense. Anything that you want them to like kind of walk away with, like, please do this right now?

Yeah, I would say number one, if you are just symptomatic, you have the symptoms that we were talking about, you're gaining weight no matter what, all the things. But you're not even diagnosed yet. You're not sure if your thyroid is involved. Then I would say absolutely come to our class. And if you can get labs done beforehand, we already went over the list of labs. Go back, rewind this, re-listen and get those labs done, even if you have to order them yourself. And don't waste a lot of time begging your doctor. If your doctor says yes, they'll give you a lab order. Go get them done. If not, go to altalabtest.com and order your own. Just get that panel done so that when you come to our live class, you're going to have that right in front of you and we're going to be able to decipher whether or not you do have a thyroid problem or not. Now, for my ladies out there that you have a thyroid problem, you're on medication and you are not asymptomatic, you are not 100%, you are still gaining weight or you can't lose, you're still losing your hair, you're still fatigued. You still have symptoms, or if you are on T4 only, like we already talked about today, if you are on T4 only, same marching orders, go get that full lab panel. And again, come to our live class because what we're gonna do is figure out, are you on the right dose? Are you on the right medication? Are you on the right dose? And this is what I teach in my book, but this is what I'm gonna go so much deeper on and get really there are things that, you know, we can't say on a podcast, right? Because it's going to be out there for the world. And then you got to have a medical disclaimer and all this. And, you know, somebody out there in the listening world can be like, hey, they're talking about medication and doses. But when we have our little intimate classes, when Natalie and I do this for you guys, we get real, real, you know. Yeah, we're going to be talking about your doses. Are you on the right dose? Do you need to lower your T4? Do you need to add in T3? Is NDC even right for you? So, we are going to get really microscopic and go deep on this class. So, get the labs done and come, and then that way you're going to know what your next step is for treatment and to get rid of your symptoms.

I love it. Okay. So, we're going to do the class one time, her and I together. So, make sure you save your spot and grab her book.

Is your book on Audible yet or not on Audible yet? Hard copy? It'll be on Audible May 12th. Yep.

Okay. So, you can do either or. I like to— sometimes I do both. Like, I like to have the hard copy and then I like to listen while I'm walking. Things like that.

Same. Yep.

Okay, I love this. Thank you so much. I'm sure I'll have you back a million more times because I always learn so much from you, but thank you for coming back again and breaking it down so simply. Thank you so much.

Love it.