Dr. Michael Ruscio | Hypothyroidism, Thyroid Symptoms & The Truth About Hypothyroid | Wellness Force

That there is this rampant and egregious over and incorrect diagnosis of hypothyroidism. It doesn't mean that hypothyroidism does not exist. Of course it does. But there have been major outcries, even published in the journal Thyroid or in Medscape, that there is this drift to incorrectly diagnosing people, albeit probably because we're trying to help them, but it ends up doing way more harm than it does good. Sam.

Michael, welcome back to the show.

Hey, buddy, Good to be here.

This is going to be a fascinating one. I personally have been dealing with what seems to be some thyroid issues, but we're going to get even more clarity today. This is your fourth time on the podcast, man. I think this is the first we've ever had a guest on four times. So thank you for coming on again.

Awesome, brother. It's. It's great to be on. And, you know, you. You pinged me, if you don't mind me kind of jumping. Right, let's do it. Let's get right in. You pinged me with kind of a. Oh, boy. You know, I could feel the fear in your email. Yeah, I was just diagnosed. Well, yeah, you told me. I've got some.

It was more like concern. It was like. It wasn't like crazy fear, but I was concerned.

Yeah. So there's some concerning stuff in my lab work, and I'm thinking, oh, boy, you know, what's going on. You send me your labs and my comment back to you is, yeah, I mean, cholesterol might be a little bit better. Perhaps we could pull back some metabolic stuff. Nothing there that I'm super concerned about, but sure, if we're trying to tune you to optimal, there's some signs of maybe metabolic excess or slowing. And then he replied, well, what about the hypothyroidism? And I said, what hypothyroidism?

Yeah.

And this is what had been concerning you. And this is a perfect example of what we had discussed in the podcast in the past, that there is this rampant and egregious over and incorrect diagnosis of hypothyroidism. It doesn't mean that hypothyroidism does not exist. Of course it does. But there have been major outcries, even published in the journal Thyroid or in Medscape, that there is this drift to incorrectly diagnosing people, albeit probably because we're trying to help them, but it ends up doing way more harm than it does good. And you're just an example of that.

Yeah. And I wanted to bring you on, because this has been your world for so long. How many years have you been involved if people haven't heard our other three podcasts, which link right here below this video. But how many years have you been specializing in autoimmune and gut health and the enteric nervous system and thyroid function like this has been a long journey for you?

Yeah, I mean, it's been about eight years from the start, although it's been about, I'd say, three or four years that I've really been honing in on. Holy smokes. There is this division within alternative medicine that's again, trying to help people, but incorrectly labeling people with a disease when they're actually in an acceptable normative range. And why this is so problematic is because literally once per week at the clinic, which is now a five doctor clinic, who are all working together to publish research and try to rectify some of this. And we're about to publish, or at least submit for publication, a case series exemplifying exactly what you've been dealing with, this incorrect diagnosis that ends up harming people. So it's only been about three years, four years that I've really been queuing in on this happening so frequently that I will see a case of this per week. It's that rampant. And coming back to that paper that was published in the journal Thyroid from 2018 by a researcher named Levadas, he wanted to assess this also in a controlled research setting. So he took a group of people who had kind of an ambiguous hypothyroid diagnosis, had them stop their medication, and then retested six to eight weeks later to see, does your thyroid maintain normal function, meaning you weren't actually ever hypothyroid. And 60% of individuals were able to come off the medication and maintain normal levels. So there is some data to show you how common this. This actually is.

All right, so what I've been dealing with over the past, I would say, 12 months plus because of the COVID and lots of stressors, you know, I'm gonna have a baby boy soon. And like, that comes with its own unique stressors. So I think it was a beaut. I thought it was a beautiful way to just be transparent and just be open and honest so that my journey could be shared with other people, other men specifically, that are dealing with some of the symptomology and also really the erroneous diagnosis of me having hypothyroid. Because, as you've mentioned, this is something that's kind of being abused right now on a large scale. So can we set the foundation of how we came together? I was working with a concierge clinic. I'm not gonna name their name, but the woman was very serious with me on our consult call, and she said, we need to put you on all kinds of medications and all kinds of supplements, and, you know, we need to really get you in the space of understanding that your body is broken. I remember she actually said that. She said, your body is broken and you need to understand that by you taking the specific drug, I believe it was. What's the specific drug?

Yeah, the thyroxin.

Thyroxine. I think there was a couple other ones too, that were like, clinical drugs. And I thought, you know, I'm gonna get a second and even third opinion. So I talked to my friend Ari Whitten. He echoed a lot of your sentiments, and that led me to you, because I trust you, man. So let's unpack this step by step for people when men or women. But we'll just speak from a man's perspective, because I'm a man. When we get diagnosed with hypothyroid, what does that actually mean? What is the truth about that? Maybe let's just start there.

I mean, I just. Firstly, let me just say I really find it disheartening the way this clinician handled the conversation. When people aren't feeling well, there's already a predilection to be a little bit anxious about, I'm not feeling well. And your mind tends to go to the worst case possible scenario, right? I've been there, right? I've bumped my shin. Didn't realize I bumped it. Felt a lump, thought I had bone cancer, right? So it's like, you know, these things happen, and if you prey upon that, it's really the wrong way to handle these conversations because you end up making the person feel worse than they actually are. As clinicians, we should be trying to leverage the placebo in a positive way, like, hey, you can heal and you can recover, and it's not that bad, and these things can be repaired. So anyway, that aside, the problem comes down to this. There's this thinking that the conventional ranges for TSH and free T4 are wrong. And if we got you or if we use these narrower criteria, we would be able to diagnose more people as hypothyroid and then get more people the care that they need, like levothyroxine or whatever type of thyroid medication that's well intentioned. But when you look at the evidence that argument has no good support for it. And I'm on the alternative side of the fence here. Right. I'm not constitutionally one who, you know, takes the other argument, but this is really where conventional medicine has it right now. What's the evidence for that statement? Well, the best evidence we have, and I'm sorry, let me take a step back and frame this. Using TSH would be the simplest way to frame this. So the cutoff point for TSH to distinguish hypothyroid versus normal thyroid is 4.5 at most labs. And the mistake that's being made in functional medicine is they want to see people at 2 or 2.5, and that's actually not how one diagnoses the diagnostic criteria. Cutoff is 4.5. However, when someone is on medication, the goal is to give enough medication to suppress their TSH to 2.5. So the myth, the mistaken inference is functional medicine says, oh, if that's the ideal level based upon medication, everyone should be at that level. It's a fair posit. Right. But there's some really compelling evidence that shows us that this is incorrect. And that evidence is looking at what's known as subclinical hypothyroidism. These are people who have elevations of that TSH above 4.5. It's anywhere from 4.5 to 10.

Right.

And these people will have that elevated TSH, they'll have normal free T4, but they'll have this kind of subclinical hypothyroidism. And the data there are clear that there's no additional symptoms in people who have subclinical hypothyroidism compared to normal, healthy controls. And there's no improvements in symptoms when giving them thyroid medication as compared to healthy controls, with one exception, two exceptions if you're infertile or if you're in your teens.

Right.

So if you're very young and infertile, then that subclinical hypothetism may benefit. But outside of those exceptions, there's a fairly robust amount of data showing that as TSH drifts Even above that 4.5, there's no additional symptoms and there's no benefit from medication. So there's really ample evidence that using a 2 or 2.5 cutoff for TSH is a really bad idea because it doesn't correlate with symptoms and those people don't benefit from medication. So your tsh, just to pull it.

Up here, we're going to go deep on this one because I can't Even imagine how many people just do what they're told blindly with good intentions. And this is why addicted to metformin and all these other things.

And this is why, back to my point, we are seeing one case per week. And I mean, I am seeing one case per week and I'm assuming the other doctors in the office are seeing about the same. That's a general consensus that when, you know, when we compare our notes, we get, and we are going to publish on this, this is going to be something that we really target with our research because it is, it's really hurting people because we have seen cases who have been tried on one medication and then a few months later, another medication. They go from levothyroxine and cytomel, then they, to armor, then wp, then a time release compounded for years. In some cases they've been just shoehorned into thyroid, never feeling any better. They come to our clinic, it's like your sleep is terrible, you have bloating, constipation and abdominal pain. Maybe this is GI driven. And in two or three months they have their life back. So your TSH was 4.09 and your T4 was 5.7. So that T4 is in the lower end of normal, but it's still normal and the TSH is also normal. This is not hypothyroidism. And if you want to, I can share this really quick on my screen just so people can see this. So here's your results. And as you can see, the lab does not flag any of this. You know, there's a 4.5 cutoff that we discussed and here's the normal range. And the thinking is, well, I know that it's not abnormal by the labs, but that's what sick, you know, sick people have abnormal. And that's true perhaps in some things, but, you know, perhaps we can look at a blood glucose of 109 chronically and say, okay, you know, that's a little higher than it should be. You're not full blown diabetes. But there's something we can optimize. There's. But that's diet and lifestyle. That's not. You have a frank disease that requires lifelong medication A and B, like we'd outlined a moment ago. There's evidence answering this question that this cohort doesn't have more symptoms and they don't benefit from the thyroid hormone. So the fact that you were told you were broken, it really upsets me because it causes harm to people psychologically, financially and medically. So that's kind of the long short of it.

Yeah. And for me, what really matters is that I had this intuition, Michael. I knew that something was off. I didn't exactly know what it was, which is honestly how I wound up talking to you here. And I think the most important thing to point out is that it is always our right to have medical and health freedom where we continually seek out the real truth and the real answers. And so when I look at some of their recommendations, and again, I'm not here to slander any company, I'm just here to promote real knowledge that actually applies to people that might find themselves in my shoes. They recommended hcg, Metformin and P Thyroid. These are all things that really just are a cog in the medical, the western medical wheel. And for some people they're needed. But for me, it was like something did not resonate both with my psyche and also with all the guests, including yourself, that I've had on the show. So from this place, is it really just about smart supplementation? Is it about lifestyle modification? You know, I can go into some of the things that I have been doing and also what are the other factors that might contribute to these numbers besides just thyroid driven parts? Right.

And there's also another concept here of, you know, a lab forward clinical model, which unfortunately much of natural, alternative and functional medicine has drifted into a model that's lab forward. And that's really a mistake for many things, not for all. There are some that are very clear, actually. Ironically, thyroid is very well steered by labs, but not incorrect interpretation of labs. And this is again where I think conventional medicine really has this. Right. But in much of alternative medicine and functional natural integrative medicine, it's labs, labs, labs, labs, labs. And what we're doing at the center is, and this works much better, is it's a supportive and therapeutic forward. Meaning here's all the therapies that have clinical trial evidence showing to help people with XYZ symptoms. And now let's organize those therapies in this cascading array of decision trees and navigate you through those until we figure out what works and gets you the result that you're looking to get. It's a much better way because many of these lab forward clinical models are predicated upon theory. It's a theory that your TSH shouldn't be above 2 or 2.5. But what we're trying to use is there's actual proof of when people have these symptoms and they make this diet change, this lifestyle change, use this supplement, whatever it is there's clinical outcome data showing it improves their symptoms. And a much better model, kind of speaking high level here, is to put that into a cascade of decision making trees that you can walk the person through until you get the result. Sure, some lab work guides that slightly, but it's really the person and their symptoms and their response to therapeutics that drives the model predominantly, rather than the other model which is just treating labs and treating numbers. And that's really a mistake because much of that is based upon theory and it's, it's treating the person is chasing a number. It's. I'm sorry, it's not treating the person and it's chasing a number.

Yeah. And a lot of the. I do think there's good intentions behind this, but like you said, one thing I noticed with this model, and I see it with a lot of concierge models, is at the end of it all there is a monthly supplement order or a monthly, let's face it, like medicine order. Right. And these things don't necessarily hit the root cause when you look at what I sent you, and maybe for somebody who's going through what I'm going through a little bit lower on the testosterone side, I'm at 358 for my total DHEA is about 100, free testosterone is 48. So I'm not necessarily high or even medium. I'm a little bit low on my testosterone. How did these things, how do these different markers come together? I understand we're not going to talk about numbers. This is about people. I'm the person sitting across from you. But when you see my testosterone and my hormones combined with some of the numbers for the thyroid, where would you go as that tree you were talking about, you know, the starting tree of how to, how to look at somebody here holistically.

Yeah. And so to the other recommendations, the metformin I think has more merit. There are other ways of starting besides metformin, but I think something that improves your metabolism makes some sense. Now, that could be diet, that could be lifestyle, that could be exercise. And how I look at that in kind of the cascading decision tree is looking at your sleep, your diet and other lifestyle factors first and then seeing how far we can get the cholesterol profile along and also how that impacts your testosterone. HCG will increase someone's testosterone. And there's more of a case to be made for something like metformin HCG in your case. But where I'd want to start is looking at your sleep to make sure that your sleep and your sleep quality is good. So I'm not sure if you're tracking with Oura Ring and you're getting consistently at least a B plus score in your sleep and modifying your macronutrients and looking at your exercise. That would be probably the best few starting points based upon what I'm seeing here.

Yeah, because my triglycerides, cholesterol, everything's really high. 355 for triglycerides and also cholesterol 6.9 triglyceride Dhdl 10.14. So like I do see potential of I went more on the higher protein like ketogenic approach. It made me feel really lethargic and sleepy. But I'm almost wondering even in some of the conversations I've had with, with Dan Pardi, the Mediterranean approach for somebody like myself. Obviously you don't know my full history, but I'll just share. I have the, the APOE3.4 allele. Some people are understanding of that, some people are not. I'm curious how you'd piece this all together.

Yeah. So I'm so glad that you asked that because that was one of the first questions I was going to pose, which is you could be someone who kind of lower carb, higher fat, metabolically does not work for them. And there is a cohort of those people out there. It could also be that you need a bit more activity or a certain type of activity change. That's most likely where we're going to get the needle to move is a combination of, okay, you're doing kind of low carb keto ish. Let's move you to more of a moderate macro composition. And also if you're doing lots of cardio, let's get some weights in there. If you're doing lots of weights, let's get some cardio in there to kind of balance out the stimuli from an exercise perspective. Glance at the sleep just to make sure. And that would really be lifestyle macros and sleep would be where we would start with this and that does. These things do have an impact on testosterone. And it's not to say that testosterone is problematic. It's another conversation. But there is this theory at least of saturation point, meaning once you get past a certain level, higher levels of testosterone don't lead to any improvement in energy libido. I don't know enough about that area to really be able to comment. Not something we manage in the clinic. So I don't want to speak too far out of my area of specialty. But that's definitely where I would start.

It's a great lens to start because we use an eight sleep bed. And I don't know if you're familiar with that. So eight sleep's really great. It has thermoregulation, so it's tracking me all throughout the night. And we get a sleep score. And so I can look at my phone here. And I know, like last night, for example, I was a 90 out of 100. So that's a great sleep score.

So.

And that's specific to me with that thermoregulation. And I really do like that. I like that I get to have some numbers I'm also wearing right now the cgm. And this is from a company called Nutrisense. It's Paul Saladino's company. So I'm noticing that, for example, yesterday was a holiday, and everybody on holidays, right, We. We sometimes eat foods that maybe aren't the best. I had a slice of, like, pie yesterday, and I was like, okay, let's just see what happens here. It took me off the charts. I mean, I was like way above 140. It lingered for a super long time. And so I'm thinking, all right, maybe this Mediterranean path is the way. And I have been doing a lot of sauna, a lot of echo bike, not necessarily weight training. And the weight training I do isn't really intense. So I'm curious to play with some of these things. And honestly, Michael, use the data to show me what's real. Otherwise, it's all just anecdotal. What are your thoughts on that?

Yeah, I mean, I agree with all of that. The one thing I would add is that there's some fairly big gaps that may occur with something like a mattress that tracks movement. And HRV or a ring data will be a little bit better. But something that we've just started using at the clinic, excuse me, is what's known as a home sleep test. So it's essentially a pulse oximeter with a microphone sensor on your chest to see if you're snoring. And we're looking at how this correlates with what's known as attended PSG or polysomnography sleep studies. My hypothesis, I want to be careful because it's too early to really be able to say how much merit this hypothesis carries. But I do have one colleague who was diagnosed with severe and also central sleep apnea. His OURA ring scores, which are better than mattress scores, was an A minus. So he had great sleep data from a OURA ring. It was miss his central sleep apnea. And it's also important to mention that there are some simple things that can be done to improve sleep quality in a cohort that may have kind of relaxed musculature in their mouth, palate and throat, like singing didgeridoo or just meeting with kind of a physical therapist for the mouth, known as a myofunctional therapist. And that same colleague actually brought. So he had central apnea plus obstructive sleep apnea. He brought his obstructive episodes down to zero after doing a course of myofunctional therapy. So this is where I think, and I don't mean to be kind of self promotional here, but I think a good clinic that that's forward thinking and not following the dogma of the field isn't going to pull you into the shoehorn thyroid diagnosis. And because they're not doing that, it reduces blind spots and then opens bandwidth for exploring other areas like sleep. So there may be something there. And you know, men are at higher risk for sleep problems than women are, so it may be due to having a higher degree of musculature. And that musculature occludes the airway. So you're more dependent on having good tone. And there's actually this is totally theoretical, so I just want to excuse in advance, but one of the things I wonder that may be leading to some of this. Well, it's twofold. What could be an increased prevalence of sleep impediment due to kind of lax musculature. It could be part of the narrowing face that Wes and A. Price talked about. But it also could be, and this is the main theory is traditional cultures, I think they sang more and I'm wondering, at least I think they may have. From what I've seen anecdotally, it seems that singing and playing certain types of woodwind instruments like a didgeridoo were more common than they are now. And those have been shown playing didgeridoo. And singing has been shown to reduce the obstructive sleep apnea because of how it improves the tone of the musculature in the palate, the tongue and the throat. So the sleep angle, that's one that we should look at. If we're seeing metabolic insufficiency, so to speak, or suboptimizations as well as you may just need to make a macronutrient shift and not say you have a disease and you're going to be on medication for the rest of your life. That's a terrible. It's a terrible thing to kind of burden someone with. Not to say that hypothyroidism is a tough thing to deal with. It's actually something that has pretty great outcomes. But we don't want to label you that out of dogma. And that's, unfortunately, that's really what it is. And if you even look at your provider, the way she handled the conversation, it reeks of dogma. Usually scientists are cautious and they're speculative and they may say, well, there's some emerging evidence that suggests you're hypothyroid because you're above 2.5 TSH. We can do an empiric trial on thyroid hormone medication and see how you feel. That would be what a conservative, cautious scientist would say. It seems like you were given much more of a dogmatic clinician narrative.

Sadly, yeah. And it almost did feel like. Not almost. It felt like there was a system that was in place and it really didn't feel too far away from being in a traditional Western medical office. And the conversations about exercise, even when I look at some of the recommendations they made, was like light walking, yoga and stretching. Because the analogy that was made to me was, you don't want to tax your engine too hard. Look how off your values are. Look at all your biometrics and how off they are. You don't want to tax yourself. And again, looking at the sleep, great. I'll definitely wear the aura. I'll maybe even reference it to the data that I get from the eight sleep and then also CGM predator foods.

I'm sorry to cut you off, but I'm happy to send you one of those home sleep tests. It's essentially a wash device that you wear for one night and you get that data. So it's actually pretty easy to do.

You know, it's really great timing. We have a company called Tatch that we're going to have on the show, and I believe it's exactly what you're describing. I need to look more into the literature, but it's something that you wear and I'm curious if it's similar to yours. So, yeah, we can definitely link all these resources down below. So, from a consultative standpoint, what I heard from you is lifestyle, nutrition, sleep check, sleep quality check. Not just length, but the quality of the sleep. Anything else that I should be aware of or anyone in my shoes should be aware of?

Well, I'd want to have you do a expanded cardiovascular panel just to see. To get a better quantification of risk. This is something that's not in my area chiefly, and it's one of the kind of interesting things about having a clinic now that's expanded is we're developing a couple of subspecialties. And my area has always been GI and also the gut thyroid connection, per our prior conversations. But one of the new doctors at our clinic is in internal medicine, and we're working behind the scenes to use kind of the same analytical processes that I've used with GI and thyroid to further develop kind of a cardiovascular risk assessment. And we don't have that fully mapped out yet. We're still kind of midstream in the review of the literature, but I'd want to have you plug in there and just do an updated profile. It's known as a VAP or an nmr, to get a better sense on what your risk looks like and make some of those modifications. So it wouldn't really be modifying much in the way of what you said, other than some additional lab work to try to clarify your risk and. And then go into those same exact experiments that you mentioned.

Is there a dream panel? I mean, the one that I got here, it seemed like there was many, many markers. I don't know how many there were total. But when you work with people, is it nice to get a snapshot of literally everything, or is it always symptom specific?

No. Yeah. I mean, it's such a mistake in thinking that labs are going to clarify everything. Labs are one third to one fourth of the information that we look at. And. And I can tell you what's far more valuable than lab work is having a meticulously crafted initial intake questionnaire where every question is an index to something that's going to be on our problems list. Does this person complain of snoring?

Right.

That's a potential. Or jaw clenching or dry mouth or receding gums. Did they have a history of braces and headgear? Do they wake up with drool on the pillow? Do they wake up in the morning tired? Even when they get enough sleep, there's a little section of the paperwork that these are all flags for potential sleep disorder, breathing. And if you build all of those things into your paperwork where you're not just asking BS questions just because some seminar told you to, which unfortunately happens a decent amount in the field. If you throw out the BS and you're really building into your intake process, all these things that when the doctor reviews them, he's already thrown out a bunch of potential problems and honed in on others and he has rationales behind them and he's even built them into order of priority. That's where the magic is. Then the labs clarify that, right? If we think, oh, maybe there's pancreatic insufficiency and they don't respond to frontline therapies for their diarrhea, now we can run that test to clarify. But the testing data, in absence of all this other kind of dashboarding, the individual is very, very harder to derive.

Meaningful information out of strength training specifically. It doesn't have to be low rep, high weight. I mean this can be like 15, 20 reps. I mean what kind of strength training do you see really make the biggest needle move for testosterone and for general health?

Yes, again, not, not my area, but from the conversations I've had with Mike Nelson who follows us pretty closely, the impact of exercise on hormones is actually fairly minimal. There is an acute perturbation of hormones, but that may be an hour of a spike of growth hormone or testosterone. But it pales in comparison to kind of the 24 hour levels. What I have heard and I haven't fact checked this yet, not to keep kind of beating on the sleep drum, but one thing that will tank metabolism and testosterone for males is an undiagnosed sleep issue.

So really getting clear on that data. I'm really excited about this because it gives me new direction. You know, all these different wellness technology pieces, they exist and they all have their own unique lane. But I think combining the aura data with honestly also the CGM that I have, that'd be fascinating to see how these sets apply. And also doing mouth taping, that's the last thing I wanted to round this out with is Mike Mutzl and I talked about mouth taping quite a bit. I've tried it. I don't notice anything because I haven't been up to watch myself sleep. But have you yourself experimented with this? Have you worked with anyone that's had success with mouth taping specifically?

I, I have experimented with mouth taping. I noticed no change in my oura ring scores when I'm mouth taping or when I'm not. What I noticed really moved the needle for me personally was exercising earlier in the day and eating earlier in the day. That was, that was fairly impactful. Now there are a handful of patients at the clinic who have really seen nice improvements from mouth taping and I suspect that mouth taping helps someone who is a nocturnal or nighttime mouth breeding. For someone that isn't really a mouth breather, it probably isn't going to vector the same amount of benefit.

I love that you talked about singing, too. We just had a blessing here from my son, and there was 30 people, and we were all singing. And I thought, this is a lost art form. And it's funny watching people, Michael. Sing that aren't used to singing. They're so uncomfortable. It's like we've lost the ability to sing. It's so interesting. I know you and I share a mentor and a friend, Paul Check, who you've podcasted with. And he brought this up to me. He was like, when did we stop singing? When do we stop dancing? When did we stop telling stories? And when did we stop honoring the mystery of life? So that is also what I'm plugging into to my healing here. So we covered some great ground in the short time that we had. Is there anything you think we missed? For somebody that finds themselves getting some numbers back that maybe produce fear, irrational, but still fear, what else can we let people know about?

Well, I think it's important to mention that even the healthiest people, you know, myself included, I think I'm pretty. Pretty darn healthy and actually perform athletically at a decently high level. Even those people have stuff, right? They have things. You know, there's good days, there's bad days, there's stretches when you feel like you're riding that wave and you're just crushing everything. And there's a moment you get knocked off that wave and you feel kind of crappy. It's important to know that because when you're in that down, knowing that that down is somewhat normal prevents you from going to the worst possible case scenario in your mind. And I would add to that that just like people come out of those downs, people come out of those downs every day. And with. With the right clinical advice, things should make sense. You should feel heard. You shouldn't feel, you know, like you're being shoehorned or like as if there's an excessive amount of fear. And I would look for a clinician who really seems to not be too confident or believe too fervently in what they say. I would almost never use that kind of language of with a patient or you have this, and this is really wrong. That's not the way the scientific and clinical process works. It's very Sherlock Holmesian. Right? It's a methodical. Well, this is suggested. And let's see how you do. And if you do well, that strengthens the rationale. And if you don't, we'll pull Back and we'll go to the other problem on that kind of list that I mentioned. We kind of dashboard out for individual at the start of their care. So I'd look for those things because people can bamboozle you who know a scientific body of evidence with factoids. It's just like when you talk to someone in finance, if you're not a finance person, it all sounds good to me. But what you want to be looking for and how you can kind of cut through is the people who seem like they're really confident and it's got to be this way and not the person who says something along the lines of, well, you know, this has worked in many cases, but there's also, you know, antithetical data that suggests this. You can tell they're really kind of looking at both sides and they're never too sure because they're keeping an open mind and looking at the pro and con data to any given point. Those are the sorts of things, those tonality and narrative pieces that I think can help prevent people from being led astray. And just keep in mind that things can be fixed. Most stuff is not that big of a deal, even though it feels kind of crushing at times.

Sure.

And sure, there are some tough diagnoses, but for the most part, we all get knocked off the horse. And a good clinician will get you back on it without scaring you to death.

Well, thanks for your knowledge and wisdom. So, obviously we've talked about this Healthy Gut, Healthy youy, which is a phenomenal resource. It's almost 400 pages. What is next for you in this functional medicine world? In this world of really, like, there's a lot of myths and there's a lot of truth in your world. So how are you going to rise to the top? And what are you guys doing at your clinic? And. And what's that like for you now?

Yeah, well, thank you for asking. It's been a wild ride in the sense that the work and the philosophy we embody at the clinic has grown so much to the fact now that we have a team of five doctors and three or four adjunctive research staff. And our aim now is to work collectively to publish literature that really answers these questions for the field, to give us some data to really rally behind and. And to try to outline the fallibility in some of these hypotheses and really publish evidence for a better way forward and also to further legitimize natural and integrated medicine. So it's a real honor to kind of be in that position. Where we can hopefully lead the field and try to reform some of these problems. And I think it's a natural growing pain associated with a field that's expanding. There's going to be some philosophy or some thoughts that weren't correct and we're hoping to tactfully help weed those out and provide a better way forward, which is a win win for everyone. It's better for the doctors and it's better for the patients.

Yeah. And it can be such a confusing world. So thank you for the clarity because the labs aren't God. Right. Labs are important, but like you said, they're a slice of the pie when it comes to a real tactical diagnosis. So where can people learn more? Obviously we'll later the book, but if they are experiencing this right now in their life, maybe they have numbers that are bringing up fear in them and they've been told, you need to take this medicine, you need to do this. How can they begin the learning curve with you?

Well, thank you. It would be an honor to help anyone who is in need of help. And if you go to drrusso.com that's-r r u s c I o dot com there's a link for our clinic there and also information for our podcast, various articles and yeah, you can plug in from there. But again, would be honored to help anyone not fall into some of the situation that you did. And I'm really glad that we spoke to prevent you from going on medication because you may have started on thyroid hormone medication and not realized for years that you didn't need it. So if we can save people from that fate, then it's a great thing to be part of.

Yes, man. And I'm excited to share with you some of the different tests and strategies and alterations that I make so that I can bring this greater world of wealth and health that I have. And it was a little scary. I'll be honest, it was a little scary. The greater world that exists though is the world of me feeling well and how great is it that my brand is called Wellness Force and I'm here having a journey of wellness. So I appreciate you man. I appreciate your knowledge and tell Michael and I see you again, we're both wishing you you love and wellness and I'll keep everyone abreast of what goes on with my situation so I can share that too. So thanks Michael.

Awesome brother. Thanks for having me.