Hashimoto’s, Thyroid Labs, and Exercise: Are You Helping Your Body or Stressing It More?

Transcript

Welcome back to the show. Today I’m doing something a little different. I asked you guys what you wanted me to talk
about. I wanted to do some solo episodes. What do you guys want to know? Overwhelmingly, the majority of you
guys ask questions grouped around Hashimoto’s. I’m going to do 3 or 4 of these, but a lot of you have great
questions about Hashimoto’s. And so if you have Hashimoto’s and you feel like every time you try to get healthier,
your body pushes back. This episode is for you. If you’ve ever thought, why am I working out more, eating cleaner,
taking the supplements, adjusting my meds, and somehow I feel more inflamed, more tired, more bloated, and more
stuck. You are not crazy and you are not failing. You are supposed to be listening to this today. Today we are going to
talk about one of the biggest misunderstandings in thyroid health. The idea that more effort always equals better
results. We’re going to get into how to exercise without crushing your recovery. Why thyroid antibodies can fluctuate.
Why some people look off in their labs but feel worse with more medication. How estrogen and thyroid meds can
interact when thyroid nodules become a bigger conversation. Why hormones, thyroid metabolism, and even blood
sugar all overlap more than most people realize. So if you’re doing all the right things and still not feeling like
yourself. Stay with me, because this episode is going to explain why.
Okay, so here we go. I am going to kind of be looking at my notes because you guys submitted a ton of wonderful
questions, but I want to start by just letting you guys know that we a lot of times with health have to zoom out. Okay.
We can’t just look at one particular thing. And this is why a lot of people get it wrong. So sometimes we have to zoom
out more is not always better with health Just because something is common does not mean it is normal for your
body. Labs matter, but context matters so much more. I say this a lot. Your labs matter. Context matters. More
symptoms are just data. They’re little gifts. And the goal is not to do more to your body. The goal is to work with your
physiology. Okay, so I hear this theme constantly. Women with Hashimoto’s are trying so hard to get healthy, and yet
they feel like their body is fighting them. And I get it because this was me. You guys remember I struggled with
Hashimoto’s for a really long time as a board certified endocrinologist. And so I understand that and I understand the
frustration. We’re walking, we’re lifting. Maybe we’re doing hits, cutting out food groups, trying to optimize our
thyroid labs. Maybe we’re adding hormones, adding GLP ones, and instead of feeling better, we start to feel inflamed.
We’re wired, exhausted, puffy, and confused. And this episode is about helping you understand what your body may
actually be asking for.
So you stop struggling with all of these things. So I had a ton of questions like, what is a good workout routine for
somebody with Hashimoto’s? Can you work out too much if you have Hashimoto’s? Why would thyroid antibodies go
up after a gut reset? Why do I feel wired when I start estrogen? Plus, I take my thyroid meds. Why do my labs say one
thing but my body feels completely different? And when do thyroid nodules, surgery or remission become part of the
conversation? As to why I’m feeling how I feel with thyroid disease? These are great questions and I can’t wait to dive
into this with you. These are going to be kind of the main thesis or themes we’re going to talk about in this episode.
So the answer is not always do more. These are the themes I’m going to talk about. Sometimes the body that looks
resistant is actually under recovered. So sometimes we push our body too hard. Sometimes a body that looks
hypothyroid on paper is also overwhelmed in real life. And that’s a problem. And sometimes what looks like a thyroid
problem is not just a thyroid problem, but it’s a thyroid plus metabolism plus hormone plus recovery plus gut
problem. And if we don’t zoom out and realize that we’re never gonna feel better, y’all. And it took me years with my
own health as a board certified endocrinologist to figure this out.
So don’t feel bad. So let’s start with exercise and Hashimoto’s. How much exercise is too much? So because this is
one of the most common and misunderstood topics, I wanted to start with this. Yes, movement is so helpful with
Hashimoto’s. No, you don’t have to, you know, be crazy and exceed expectations just because you have Hashimoto’s.
And I don’t want you to fear exercise either. But there is absolutely such a thing as exercise that exceeds your
current recovery capacity. So with Hashimoto’s, we want you to exercise, but honestly, hit exercises and some of this
crazy stuff you see. Not good for us Hoshi girls, because a lot of times our adrenals are affected as well. And so if you
feel wired and tired, if your adrenal is affected because you have Hashimoto’s and you are gaslit for so long and you
didn’t realize you weren’t getting better and you couldn’t find somebody to help you, then pushing yourself with
extreme exercises does not help your Hashimoto’s. It actually makes it worse. So I got a question. What is a good
workout routine for somebody with Hashimoto’s? Walking strength training. How much should we be doing per week?
I’ve heard you can work out too much with Hashimoto’s. Great questions. Let’s break this down. First, Principal
Hashimoto’s does not mean don’t exercise. I want you to exercise. It means your exercise should match your
capacity. So we don’t want to overdo it.
If we overdo it with Hashimoto’s, we’re going to end up with poor sleep because we’re pushing ourselves too hard.
We can’t recover. We’re going to have blood sugar instabilities. If we’re pushing ourselves too hard, we’re stressing
our body out, stressing our adrenals more. Cortisol is made, which spikes our insulin, which then affects our blood
sugar, which is going to make our blood sugar dip. It’s going to affect our sleep. It’s going to affect our recovery. If
we’re under eating because we’re worried about gaining weight with Hashimoto’s, that’s going to make all this worse.
Your cortisol is going to be higher, your insulin is going to be higher. You’re going to feel less recovered if we’re not
getting enough protein, but we’re exercising, we can’t build muscle, y’all. You cannot build muscle without enough
protein. So you’ve got to be eating your protein. So we can’t be under-eating. We’ve got to get our protein. We don’t
want to push too hard if we’re chronically in a calorie deficit or we have a high stress life. So a lot of us Hashimoto’s
girls, we’re stressed. Everyone’s stress life, right? When you’re chronically stressed. Plus now you’re depleting your
body of excess calories, you’re restricting too much and you’re pushing too hard with exercise. Guess what? Not
good. Our adrenals, they give out. We’re stressed. Our adrenal veins go crazy. We release cortisol again, it releases
insulin. It’s going to cause us to get swollen, to retain fluid, to store our food as fat, instead of utilizing it as energy.
It’s going to tell our body when we eat hay, store all that food and our fat cell instead of going to our skeletal muscle.
And so then even if we are eating and we’re eating our protein and we’re exercising, it’s going to be harder for us to
make muscle because our insulin is high and we’ve stressed our body out. And so that insulin is going to signal where
the food goes. So our body can work against us. And also if we’re overexercising and we’re stressing ourselves out
and we affect our gut, a lot of times chronic stress affects our gut. We end up with things like H. Pylori starts eating
our iron. Guess what, girls? When our iron is low, especially with hashi’s, it affects our thyroid function. So when you
have low ferritin, your T3 that you need to feel better can’t get into the cell. So then when you have low ferritin,
that’s going to make your fatigue worse because your T3 isn’t working, your hair is going to start falling out. You’re
going to be cold, you’re going to have restless legs. All of this is going to cause your inflammation to be worse. High
cortisol, high insulin, low ferritin, T3 not working, not being able to recover. And then no matter what, if you’re taking
thyroid medication and you’re working with the best provider and they’re monitoring your labs and trying to get your
T3 to be optimal for four and a half, you’re not going to feel it because you’re inflamed, because you’ve over
exercised, because you’ve stressed your adrenals out, you’ve driven your cortisol up, you’ve driven your insulin up.
And so then your thyroid medication will not be optimized no matter what your provider does. So you have to go back
and realize that your thyroid is connected to your adrenal, and that your adrenal and thyroid is connected to your gut
and your stress. So Overexercising is not the answer for a lot of women. It’s not that strength training is the problem.
It’s that strength training on top of poor recovery, poor fueling, poor sleep and unstable thyroid status becomes the
problem. So keep that in mind. It’s not that you can’t strength train, it’s that we need to be cognitive of what we’re
doing with that. And if you’re gonna do a hit routine, we’re doing one a week max. We’re making sure that we’re
getting our recovery in. We’re getting our protein, we’re getting our rest. Okay. So walking is great. I walk every day.
I love it on days where I’m just like, I can’t work out. I’m tired. I go for a walk. Sometimes I go for a walk for an hour.
Sometimes I split it up 30 minutes, 30 minutes. But walking is great and it counts. Strength training is good too, but
we have to make sure we have proper recovery.
We have proper fuel, enough protein, enough calories. We’re sleeping well and our thyroid status and adrenal status
is good. So don’t be doing hit exercises when you feel terrible. And I tell people when you go exercise, exercise
should make you feel better. If you feel more depleted after you did exercise, that’s a problem. So from a practical
standpoint, if you’re listening to this and you have Hashimoto’s walking, do it every day, or at least almost every day,
not going to hurt your thyroid. Wonderful for fat metabolism, wonderful for mood, wonderful for recovery, good for
your muscles. It’s an excellent, excellent buffer for blood sugar because when you eat and your blood sugar goes up,
walking helps that. It helps regulate your nervous system. It calms you down. It helps with recovery. It helps with
digestion. It helps with inflammation. It’s just something that is very powerful because you release myokines when
you walk as well, which are good for your mood. It is especially helpful after meals for our PCOS and Hashimoto’s
girls, because when we have insulin resistance, our blood sugar goes up right after we eat. If we walk, that tells our
body, instead of shunting our food to our fat cells, where it’s going to cause us to retain water and gain weight. When
we walk right after we eat, it pushes the food that we ate into our skull to muscle so that our skeletal muscle can
utilize it for energy.
So I love, love, love walking again. I do it almost daily. Let’s talk about strength training. Ideally, if you have
Hashimoto’s, do it 2 to 4 days a week. We don’t have to do it every day. I used to think, oh my gosh, I have to
strength train every day and I would be so sore and so tired and I wouldn’t sleep all night, couldn’t I couldn’t figure
out like, why am I not gaining muscle? Like, why is my body composition almost looked worse? I almost looked
doughy because I was so inflamed and stressed. So 2 to 4 days a week. Fine. Do one upper body day. Do one lower
body day. Do a full body day on the other days. Walk. Do yoga. Stretch. But you don’t have to do it every day. Do
compound lifts. Progressive overload. Make sure you get enough rest. So now when I lift, I might do like five exercises
total for upper body, five for lower. You don’t have to do a million exercises, and you don’t have to do a million reps
or a million sets. Just work with progressive overload, meaning as much weight as you can. Ideally, we’re doing 6 to 8
reps. Don’t hurt yourself. Rest in between. Not every session needs to leave you destroyed. I think people forget that
too. You don’t need to feel destroyed when you’re done exercising. You just need to feel better. So keep that in mind.
High intensity exercise like the hit stuff. Again, it can be appropriate for some people. I wouldn’t do it more than once
a week. You don’t want to do too much. You don’t want to do it too early, especially if you’re already symptomatic. I
would never I used to get up at 5 a.m. and go to Orangetheory. I would never do that anymore. You guys, it is so bad
on your adrenals. Do not pop out of bed and go do a hit exercise. If you’re going to do hit, do it on the weekend. Do it
after you’ve gotten up, you’ve walked, you’ve put some protein in your body. You’ve fueled your body. Then go do
the hit. Do not do that on a fasted stomach, you guys, especially if you’re a hashi’s girl, your adrenals are already
probably depleted. We do not want to do that to our thyroid. Avoid using intense workouts as the primary fat loss
strategy. I promise you, you will lose more fat if you will walk. I love to walk on a 10% incline, but I didn’t start there. I
started on a 3% incline and then I went to a four and then a five walk on a 3% 4% incline walk for 30 minutes. If you
get to where you’re used to that, you can hold 1 or 2 pound dumbbells. It is so hard, y’all, but you do not need to use
high intensity as a fat like the only way to burn fat.
I promise you will burn excessive amounts of fat by just walking. Here are some signs that exercise is overshooting
your capacity. So if you feel worse fatigue after you have exercised. If you start to have sleep disruption on days that
you exercise, if you have increased soreness that is lingering more than a day or two. If you have higher food
cravings after you exercise, if your cycle starts to become disrupted whenever you change exercise, if you’re feeling
wired after workouts instead of pleasantly tired, if you’re more bloated, if you start retaining more fluid, if you have
worse constipation, or you go the other way and have loose stools, if you are needing caffeine to function or finish
your exercise, or if you’re plateauing body composition despite doing more, then those are signs that you are
overshooting your capacity to exercise with hashes. Because again, our adrenal, our gut, our insulin, our cortisol, our
hormones, they all work together. The best workout for Hashimoto’s is not the one that burns the most calories. It’s
the one your body can recover from and adapt to. So I see women who are all the time in my clinic who are walking,
lifting, fasting, keeping calories really low, maybe doing cardio on top of that, and then wondering why they cannot
build muscle and why inflammation seems worse and they think they have a willpower willpower problem. This is not
a willpower problem.
This is often a physiology and recovery problem. So this is where thyroid antibodies and labs can get confusing
because people assume every change means something dramatic is happening. So in that person, I just talked to you
about that person who is exercising and fasting and doing all these things and trying to throw cardio on top of that,
they may think, oh my gosh, I’m doing everything right. They come to me, their antibody levels are high. Their T3 is
not perfect. We’re working on it. And then they’re doing these things that stress their adrenal. And guess what, y’all?
When we look at their labs again, their adrenals are worse, their TPO antibodies higher, their T3 levels are lower, you
know, and then they’re like, well, I’m doing everything right. Why are my labs going up? And so it can be because
you’re overexercising, you’re not recovering well. So keep that in mind. So this kind of leads me into another section
of questions a lot of you answered, which is why thyroid antibodies fluctuate. So somebody asked, is it normal for
your TPO and TG antibodies to go up after a gut reset protocol? I’ve had this asked a couple times because we do a
lot of gut stuff with modern endocrine. I truly believe if you want to fix an autoimmune condition and you want to be
in the best health or shape possible, you have to fix your gut because so much inflammation starts in the gut and
inflammation is the root cause and the driver of so many chronic conditions, including thyroid disease.
So I’ve had several people ask, is it normal for your TPO or TG antibodies to go up after a gut gut reset protocol? This
person’s went up, plus their TG antibody went up. So TPO and TG antibody, which had never happened before, they
were on LDN. And at the time they also took a microdose of GLP one. So they’re not sure how this happened because
they were doing all these things to make their inflammation better, right? So they were they did a gut reset. They’re
doing LDN, they are doing Microdose, GLP one, and TPO antibodies had never went up. They were working on coming
down. And then all of a sudden they’re going up. And so this is a really important question because people get one
repeat antibody panel and they panic. Remember that your TG and TPO antibodies, a lot of times are a reflection of
what happened 3 to 6 months ago. So also, I don’t love to check these like some people want to check them every six
weeks. And I’m like, you guys, they don’t change that often. And so one little thing could skew you from a 200 to a
240, where if we just waited a little bit more time, your 200 would have eventually went back down to 180. So keep
that in mind.
And a lot of times this is a reflection of past time. Like it’s not immediate, almost kind of like an A one C like an
average over 90 days. And so I don’t want one lab to make anyone panic ever. And antibody increase is not
something to ignore. It’s serious. It’s a symptom. It’s a signal, but it also does not automatically mean the protocol
harmed you or that the disease is spiraling. So keep that in mind. Context. Big picture. Remember, we have to look at
everything together. Possible reasons that your thyroid antibodies fluctuate. Let’s talk about these because this is
important. Immune system variability meaning did you get a virus. Are you so stressed that your gut is affecting your
immune system? Remember, 70% of our immune system lives in our gut. We can see this on lab testing that we do
gut testing at Modern Endocrine. If you are completely stressed, it will affect the immune system of your gut. Lab
timing differences can cause this acute stress. So let’s say you almost got in a wreck on your way to the lab to check
your TPO antibody. That could affect it. Poor sleep. If you get poor sleep 3 or 4 nights in a row before this, definitely
going to affect it. Infection or immune activation. Calorie restriction if you’re on some sort of new diet, gut
inflammation. So maybe we were working on cleaning your gut out. And in doing so, you have caused some
inflammation to still be present.
Like we’ve gotten rid of some of the bad bacteria on the way out. It’s led to some inflammation and we’re still
working on that postpartum or hormone shifts. Any hormone shifts can affect your TPO antibodies, medication
changes, intense exercise load. So again, intense exercise. Not our friends with Hashi, not our friend. If we have
hashi’s you guys. So we don’t want to be overexercising and then not enough recovery. And that’s mental recovery.
That’s physical recovery. That’s exercise recovery. So antibodies are one piece of the story. But I also want you to
look at your symptoms if your symptoms of hypothyroidism have improved but your antibodies have gone up.
Obviously something is not right there. Zoom out. Let’s look at the big picture. I want you to look at your thyroid
hormone levels again. If your thyroid hormone levels are getting better, but your antibodies are going up, maybe
your antibodies are going up from something three months ago or some acute illness that you have. I want you to
look at your energy. Is your energy improving? What about your digestion? Is your digestion better? Your body
temperature tends to be very relevant when your thyroid person as well. Is your body temperature running cold? Are
you running high? What about your cycle health? When cycles get better in any of my patients with Hashi’s or any of
my hypothyroid patients, all of you girls, when your cycles are normalizing, your Hashimoto’s is getting better.
I don’t care what your antibody is doing. It’s getting better. Your sleep. How is your sleep? How are your other
inflammation markers, your CRP, things like that. And then overall trend, not just one isolated value. So I want you to
remember a lab trend without context creates fear. A lab trend with context creates a clinical picture. So I’m gonna
say that again. A lab trend without context can just make you fearful. If you’re just looking at your TPO and it goes
up, you might freak out, but a lab value with context creates a clinical picture. So if your TPO is going up but your
symptoms are better, your thyroid levels are better, your digestion is better, your cycle is getting better, your sleep is
getting better. Don’t worry about that individual lab. Okay, so what I do not want you to do is don’t automatically
assume the gut protocol caused the permanent harm. If your TPO antibodies started going up. I don’t want you to
chase every single lab movement reactively. I don’t want you to keep layering interventions just because you feel
scared. I want you to step back and listen to your body zoom out. So if the immune system is already sensitive,
sometimes any major shift dietary, antimicrobial, hormonal, sleep related or metabolic can temporarily change the
picture. So maybe your adrenals and your thyroid were just so overactivated and stressed out. You threw one little
change in there.
Even though maybe it’s a good change, it’s starting to help you and your TPO antibody goes up. Do not lock in on
that and lose your mind. That does not mean that you have to ignore the TPO antibody going up, but it means you
zoom out and you ask what else changed around the same time, I can assure you that gut health protocols do not
typically cause TPO antibodies to go up by themselves. Now, the LDN and the GLP one nuance with this particular
patient’s patients. Question. Ldn is not a guarantee that antibodies will always drop. Not everyone’s antibodies drop
on LDN. Some people do really well on it. Some people don’t. There are side effects with LDN. Some people get
headaches. Some people get very strange dreams every time you adjust someone’s dose. Like typically we start LDN
at 1.5. Some people then go to 22.53. I tend to go from 1.5 to 3 to 4.5, because every time you adjust somebody’s
dose on LDN, they can get side effects. So LDN is not a guarantee that your antibodies will always drop. And GLP one
response can vary over time. So changes in your appetite because of a GLP one changes in your intake, your body
stress, your blood sugar, and your inflammation, which GLP one effect can all influence how someone feels. So not
everyone is going to have the exact same response to a GLP one. Now, at Modern Endocrine, we use tiny, tiny doses
for inflammation with Hashimoto’s patients.
And typically our patients do great. They don’t have issues with nausea. They don’t they just don’t have bad side
effects. So typically those people do really well. But it’s going to depend on how high of a dose you’re taking and
what it’s doing to your particular body. Also, if your adrenal is chronically stressed. So if you start a GLP one, you’re
burning your candle at both ends. You’re not sleeping well, you’re stressed. Plus then you throw a gut protocol in
there. I mean, obviously that’s going to be different than somebody who is in a good place, not overly stressed, ready
to do the gut protocol, sleeping well. So keep that in mind as well. The LDN and the GLP one, not necessarily a cause
for the TPO antibodies to go up or down either. That wasn’t really a direct question, but I wanted to talk about that as
well. So this is also why medication conversations can get so tricky, because many women start changing doses
based on symptoms alone or labs alone, when in reality the answer is in the relationship between the two, the
symptoms, and the labs. So just keep that in mind as well. Just because your TPO antibody goes up, I don’t want you
to think, oh my God, I got to start taking more LDN or I need more of a GLP one or I need more thyroid medication.
If your symptoms show that, sure, then let’s do that. Also, why you really need to work with a provider who
understands, zooms out and understands how all this goes together thyroid, adrenal, gut hormones, it’s all a big
picture with your labs and different things can cause your labs to change. But I do think that’s a great question and
people ask that a lot. And so I thought it was important that we talk about it. Now, I want to also talk about thyroid
medication nuance when labs and symptoms don’t match, because a lot of people ask about this too. So I want this
section should be extremely helpful and very shareable. If you know people that have hypothyroidism or Hashimoto’s
and you’re like, wow, they have symptoms that don’t match their lab. Let’s talk about this. Okay, so one of the other
questions I get all the time, I started the lowest dose of a Dotti estrogen patch, but it makes me feel wired with my
thyroid medication. I get this a lot. I started estrogen and now I’m feeling wired with my thyroid meds, so I kind of cut
them in half myself because I don’t go to the doctor for six months. If you are somebody who’s listening to this and
you’re only seeing a doctor every six months, but your thyroid and hormones are not stable, that is crazy. And it’s
going to take you years to figure out how to get better.
You need to be seeing with our modern endocrine patients, our PCP patients, we see them every month so that we
can get them feeling better quickly. At a minimum, every three months, you need to be seen. Otherwise, it’s going to
take years to get better. But this person is not going to go for six months. So they kind of cut their medicine in half
and they felt fine. Then they cut it in half. But when they did the blood work, their blood work was showing that
they’re too low in their T4 and their T3, but they feel like they can’t tolerate higher doses. So basically what they’re
saying is I was doing okay, I started estrogen, then I didn’t feel well, so I cut my thyroid medicine in half. Then when I
did my labs, my labs looked low. But when I go up on the thyroid medication, I can’t tolerate it. So what do I do? So if
this has happened to you again, step out. Zoom out. Remember, we’re not looking at one thing. We’re looking at a
systematic approach of how everything works together and symptoms. Another question that was similar to this. My
doctor has me on half of a five mcg pill of liothyronine or cytomel. So it would be 2.5 half of that every morning with
my 75 micrograms of Synthroid. None in the afternoon. Do you think I should be taking the other half in the
afternoon? So they’re asking.
I take Synthroid in the morning and I take half of a five of Cytomel in the morning. Should I take a half of 2.5 in the
afternoon? So these are both really good medication questions. This is where people get trapped between the lab
and what the lab shows and what their body really feels. And I think this is important too. And you need a provider
that understands this. And this is why it’s important to know. I ask all my patients, how do you feel? And I want to say
this very clearly, if your body feels terrible on a dose, that matters. I don’t care what your labs are showing, but that
does not mean that self-adjusting long term is the best solution either. So I want you to feel like you can talk to your
provider. You should. Because again, like you shouldn’t be out there just trying to self titrate things. They should be
helping you figure out, hey, if this happens, like we tell all our patients when we start them on medications,
especially T3 medications, Liothyronine Cytomel thyroid armor. Hey, when we start this, if this is too much for you,
these are the things you’re going to experience. You’re going to be jittery. You’re going to have palpitations. You may
have diarrhea. Get hot. Like they should explain these things to you. If that happens, cut it in half. They should give
you some sort of plan or be able to talk with them on a portal.
Call their office. You should be out there just trying to willy nilly at yourself. But also, if your body feels terrible on a
dose, that is a symptom, that is a sign. And it doesn’t necessarily matter what your lab shows. If you feel terrible, we
need to figure out why. Is it that maybe that medication can’t work? Maybe actually that is too high of a dose, but
your labs still look low because that medication can’t get into the cell because you have inflammation, because
maybe your insulin is high or you’re chronically stressed, you have leaky gut, you’re going through menopause and
your hormones are shifting. Maybe your liver isn’t working well. You’re not processing toxins through your liver. Your
bile isn’t flowing well. You’re not pooping every day. I mean, there’s so many reasons, again, nuanced, but this is why
you have to talk to your provider and your provider has to talk to you to help figure out the right dose of medication
for you. So let’s talk about why somebody might feel wired with thyroid medication and possibly estrogen. So some of
the reasons this can happen too much thyroid hormone relative to your current tolerance. Now that doesn’t mean it’s
too much for you long term. What that means is like when I first started T3 medication, y’all. So my T3 was like 2.5. I
don’t know how I lived. It was 2.5 for years and they were just like, oh, well, that’s normal, you’re fine.
And I had every symptom of hypothyroidism, but it was that low for years. So when I first was like, okay, I’m gonna
take some T3, I took a tiny amount of T3. My T3 went up to 3.1. I thought I was dying, I was having palpitations, I was
hot, I was just like, because my body wasn’t used to that amount of thyroid medication or that amount of thyroid
hormone, even though that’s still low. It was like I was so suppressed for so long, so I had to take the tiniest dose of
T3. And my T3 was like went from 2.5 to 2.8 for like a month or two. And then I was like, okay, let me take a little bit
more. And then I got where I could handle 3.1. And then I got to where I could handle 3.4. Now, in the interim of this,
I mean, this took me months and now my T4 is now my T3 is in the fours and I feel amazing. But in the interim of all
of this, I was also working on cleaning up my gut. I was lowering the inflammation in my gut. I was working on adding
back progesterone because I was progesterone deficient, which was driving up my cortisol. So as I added back
progesterone, it was lowering my cortisol, which then also lowered inflammation so that T3 could work.
I was working on my bowel flow and making sure that I could go to the bathroom every day. I was working on my gut.
So much gut work. I did a year of gut work. I had everything wrong with my gut, you could imagine. So I was working
on things to help lower inflammation and help get rid of toxins in my body through my liver and bile clearance so that
I could actually tolerate the T3. So that’s kind of a common thing that can happen, to be honest with you, but it can
be that you have too much thyroid hormone relative to your tolerance. It can be that your cortisol and your nervous
system are dysregulated. That’s like everyone in the world. We are. There’s so many beeps and buzzes and lights and
just so many things to do. Our cortisol is dysregulated, y’all. And when that happens, it will affect how our body
metabolizes and processes our thyroid medication because it causes inflammation when we’re chronically stressed, it
affects our gut, and our gut directly affects how our thyroid hormone converts. And it affects our insulin, our cortisol,
our sleep, everything. Now estrogen, it shifts changing binding proteins or perceived sensitivity to binding proteins.
So when our estrogen levels are low or high, it actually affects something called sex hormone binding globulin and
thyroid binding globulin. These are transport proteins that are made in our liver that then can help move thyroid
hormone throughout our body.
So also when our estrogen is low, it affects our gut. So when we don’t have a steady stream of estrogen, when we’re
in perimenopause or menopause, certain bacteria die in our gut, which then affects our estrobolome. So now we’re
not metabolizing our estrogen hormones as well. We are also not able to move things through our gut as well. It
slows down peristalsis or movement through our gut. It slows down our body’s ability to process other hormones,
progesterone, etc.. So just the loss of estrogen has astronomical effects on our gut. I talk about all this in my book in
depth. My book fixture. Gut fixture. Hormones, you guys. There’s chapters on this which where I just explain how
estrogen and thyroid hormone affect each other and insulin and cortisol, but all of those things will shift estrogen
changes, shift binding proteins, and then the perceived sensitivity of your hormones in your body. If we’re under
fueling our body, it’s going to make it worse. We’re going to feel wired. We’re going to be, you know, our insulin and
our cortisol are going to be higher because when you fuel your body, your adrenals are high alert. If we have anemia
or low ferritin, I kind of talked about this. If our if we have gut issues, we’re bloated, we have H pylori, we’re stressed
and we end up with H pylori and it’s eating our iron. If our iron is low or our ferritin is low, we can’t even utilize the T3.
We can’t utilize the T3 that we’re taking or that our body is trying to convert from T4. So that’s a problem. We have
blood sugar instabilities from high insulin, which we’ve talked about how high insulin, you know, from stress, from
what we eat when we have high insulin and blood sugar instabilities, that can cause us to feel tired and wired at the
same time when we get poor sleep, because poor sleep drives our cortisol up, when we add multiple things at once,
again, when our adrenals are overtaxed and we’re adding thyroid hormone and we’re adding estrogen and we’re
adding a GLP one, we’re adding LDN. Sometimes that’s too much. We can’t do that. Our body’s like, whoa. And again,
the T3 sensitivity thing, I explained with me that can cause these symptoms as well. So there’s lots of reasons when
you have Hashimoto’s, when you’re on thyroid medication and you’re adding estrogen, that you could feel wired or
even just when you’re on your thyroid, when you’re on thyroid medication, some people feel wired with hashi’s. They
say, I’m wired, but then I’m so tired and my body is physically tired. When I lay down, I’m so tired, but I’m wired.
These are the reasons. Now I want to talk about labs versus symptoms. The concept again, we’re going to zoom out,
come back to this because it’s so important. You guys, some people are under replaced and they still feel
overstimulated like me, Like I told you about, under replaced, felt overstimulated.
That’s a problem because your body, your mitochondria, your fat cells, your metabolism, your hair, everything needs
T3, your brain. But when you’re under replaced and you can’t take more because it makes you feel overstimulated,
that’s a huge problem. So you have to step back and figure out why are you feeling overstimulated. Some people
have poor T4 to T3 conversion. That’s a problem. And so a lot of people that feel really bad or poorly, it’s because
their T4 is not converting to T3. If you’re listening to this and you’re mostly on T4 medications or no T3 and you’re
inflamed, you have insulin resistance, you feel stressed, you have gut symptoms, you’re going in, you’re in
perimenopause or in menopause or going through a hormonal transition. And you are not on T3 and you have a
thyroid disorder. You’re not making T3 out of T4. So you’re not going to feel well because the thyroid medication
you’re taking is not what’s best for you. Some people tolerate dose changes very poorly. So when we change
medications, if we don’t have a functioning, really good insulin level and a functioning gallbladder and our gut is
functioning well, and our progesterone or estrogen cortisol, if everything’s not in balance and functioning well, when
we change thyroid medication, some people feel terrible. Some people need dosing timing adjustment. One of the
questions I got was, should I be taking liothyronine or cytomel in the morning and in the afternoon? A lot of times,
yes.
Because if you take a T3 and five hours later you’re tired, you need an afternoon dose. T3 doesn’t last all day. So
sometimes it’s just we need a medication dosing adjustment or timing adjustment. And some people have symptoms
driven by nonthyroid issues layered on top. This is something that we are so passionate about at Modern Endocrine.
Your gut, your hormones, your sleep, your nutrition, your movement, your relationships, your self-talk, your light
exposure. So many things affect your thyroid because they affect inflammation and inflammation drives whether T4
can convert to T3. And so it’s not just your medication. And the answer is not always throwing more medication at a
problem. It’s figuring out why the medication is not working in the first place. So a higher thyroid dose, it’s not always
the answer. And if your body cannot use or tolerate what you are already giving it, you’re going to have a problem.
So a lot of people feel wired but tired because the higher dose of thyroid medication somebody is trying to push on
you either is not the right type of thyroid hormone, it’s T4 and you can’t convert it to T3. So you just have all this T4
floating around, which by the way, when you have high T4 levels, it increases reverse T3, which is inactive and lowers
free T3.
So it’s just going to make you feel worse. So if you’re on too much T4 100%, it’s going to make you feel worse. So the
answer is not always throwing more medication at the problem. It’s figuring out why the medication you’re giving
someone is not converting the way it’s supposed to, and what other things when we zoom out, big picture is causing
it not to work. So liothyronine timing. Let’s talk about this. Keep this measure right. So let’s talk about T3. We want to
make sure that you’re looking at T3 levels. And then you’re correlating those to your symptoms. T3 is fast acting
okay. So it’s not like levothyroxine. It’s not one of those things. You can take it once a day and it’s going to last for 24
hours. It’s really not. It’s pretty fast acting. Some people do better with split dosing. I would venture out to say,
actually, more people do better with split dosing. Some do fine with just morning doses. But those are typically
people who maybe have less inflammation or just are not as sensitive to their symptoms. Do not like there should
never be a blanket rule with T3. It’s not like everyone gets it just in the morning or everyone gets it twice a day. I
don’t I don’t think that’s right. I always start people on T3. I personally like to start everyone on some form of T3. So if
you’re on Synthroid, you’re getting cytomel, Liothyronine or armor or thyroid with your Synthroid if you’ll allow me to
do that, because most people can’t convert their T4 to T3 because of all the inflammation.
So never a blanket rule. Some people just get T3, so it just depends. Some people I really like Ren Thyroid. I think you
guys know I personally take Ren thyroid. It’s a desiccated thyroid hormone. It has T4, T3, a little bit of T1 and T2. It
just keeps my body from utilizing more energy of converting a lot of T4 to T3. It’s already done for me. I don’t need to
worry about that. There’s enough stress in the world. I don’t need my liver worrying about it. You know, I’ve already
got a little bit of insulin resistance because I’m a PCOS girl too. So I choose to take T3. I dose it twice a day. I can tell
a difference. If I don’t. I take it when I first wake up in the morning, which is typically around six by 1:00, if I haven’t
taken another dose, I can start to feel like mm. And if I don’t take it by 330, my brain is done. That’s because T3,
typically within 5 to 6 hours is going to be metabolizing itself out. And I do not have the luxury of not being on, you
know, all day. I need to know what’s going on all day so I can’t let my T3 just wear out at 1:00 or 2:00.
So I take split dosing. Some people don’t feel like that though. Some people say, oh my gosh, I have great energy for
my T3 all day long. Okay, fine. Then take it once a day. So not a blanket rule, but I would say that most people feel
better on T3 twice a day. Context matters with T3, your symptoms, your labs, your sensitivity, your provider’s
guidance, rhythm of the day, etc. so there’s not a blanket statement. I can’t answer that. Like, should I just take it in
the afternoon? It needs to be based on your symptoms, your labs, and then an educated conversation with your
provider, keeping into account, you know, do you have inflammation? Is your CRP high? Is your insulin high? Are your
hormone shifting? Are you in perimenopause? Do you have gut symptoms? All those things will help guide the best
way to take your T3, estrogen and thyroid. So I want to explain that as well. Estrogen can affect thyroid hormone
dynamics 100%. I told you a little bit about how estrogen affects our gut, which ultimately affects how our thyroid
hormone converts hormone shifts can change how thyroid replacement feels if someone starts estrogen and
suddenly feels off, that deserves a reevaluation. Not like don’t panic, don’t like stop everything that you’re on.
Typically, I tell a thyroid patient, if we start you on estrogen and something’s off, then let’s stop the estrogen. Don’t
stop your thyroid medication and let’s reevaluate the form of estrogen.
We gave you the dose, the frequency, like, is it your gut? Most people that take estrogen and have bad side effects of
estrogen, it is a recirculation metabolism issue. So we need to figure that out. Do not interpret one symptom in
isolation. Remember, any time we take estrogen or progesterone our body has to metabolize those hormones.
Hormones are never evil. They are never the problem. It is how your body metabolizes those hormones, the
environment, those hormones go into. And so if your bowel is not working. If your bile flow is not working, if your liver
is not working, then when we give you a hormone like estrogen, you’re not going to feel well because there is
something called estrogen metabolism. There’s phase one, phase two, phase three. It happens in your liver. Talk
about this extensively in my book to explain all of it to you. If those phases cannot happen in your liver, which require
things like glutathione, methylated B vitamins, NAC, all sorts of things. If that does not happen in your liver and the
step that it’s supposed to, and your estrogen doesn’t metabolize through your liver and then get excreted in your
bowel, in your feces, it gets recirculated in a lot of people because our gut microbiome is off. Our estrobolome is off
when it recirculates that’s what causes these symptoms. It’s not the estrogen, it’s the environment we put it in. And it
doesn’t matter how hard you push or how many different ways you give that person estrogen, it’s probably not going
to go well.
And it doesn’t matter what you do with their thyroid medication. So again, we have to zoom out. We have to figure
out, okay, what symptoms did you have when you started the estrogen. That usually tells us is it estrogen
dominance, which it usually is. And then it’s not that we necessarily need to change our thyroid hormone, it’s that we
need to figure out what’s going on with your gut and your liver and how we can metabolize these hormones better.
So do not interpret one symptom in isolation. When estrogen, thyroid hormone nutrition, and nervous system status
are all changing at the same time, it can feel like your body is speaking four languages at once. That can happen. So
it’s important that we’re kind of setting the foundations, that modern endocrine. We look at your cell membrane
health, we look at your gut health, we look at your micronutrients, and then we look at your hormones. So we’re
setting the foundation so that the hormones work correctly in union instead of all chaotically at once. So that is
something that’s important as well. Now I want you to avoid self-cutting or self escalating medications repeatedly.
That’s not safe. You should be doing that with a provider, right? So if my patients are having issues, I give them
parameters. I give them guidelines of what to do, but I also tell them to message me.
So be careful with that. You don’t want to be adjusting your medications on your own. It’s not safe, especially if you’re
not seeing someone for six months. That’s crazy. Don’t make weekly medication changes based purely on day to day
symptom swings, because that’s not going to help either. You’re going to be making changes based on something
that maybe happened a long time ago. And if you’re making too many too quickly, that’s going to be a problem. So
again, this is where you need your provider to help you and you want to get proper follow up when possible. So I
don’t want you just, again, changing medications and not having somebody help you with that. So make sure that
you have the right provider helping you with that. Okay, then I want to, I had a lot of questions about like bigger
picture thyroid questions. The ones that carry a lot of fear are things like thyroid nodules, surgery. Does Hashimoto’s
ever really calm down? So let’s talk about some of those questions as well. So I had a question. How do you know
when to have a thyroidectomy. So depending on what’s going on, when should I have a thyroidectomy? Is there any
way to get rid of nodules or restore the health of the thyroid to prevent surgery? Is it possible to put Hashimoto’s into
remission and have PCOS under control? So these are all great questions.
They come with so much emotion because the thyroid feels deeply tied to your identity, to your energy, to your
metabolism, to your long term health. And hearing words like nodule or surgery can immediately make people feel
like they’ve failed or like their thyroid is beyond help. And that is not necessarily true. Keep in mind, you guys, I had
thyroid nodules, I had Hashimoto’s, I had graves before that I was told to have a thyroidectomy. It’s scary. Okay, so I
would say that you definitely need a provider that understands holistic approach before you go getting a
thyroidectomy for Hashimoto’s. Because even though your thyroid may not be working wholly, it still makes some T
one some T two. So once you get a thyroidectomy game over. So I am very cautious about recommending
thyroidectomies to patients. Even if they have nodules. There are guidelines you go by with nodules. So if your
nodule, there’s a percentage, you can tell someone how likely it is that this nodule is cancerous based on a biopsy if
they need it. Depending on how big the nodule is, I will tell you with Hashimoto’s and really high TPO antibodies,
especially if you have multiple nodules, the chance that you have cancer with Hashimoto’s is lower. But again, it
depends on the size of the nodule, how many you have. And you should probably have a biopsy. So lots of great
questions, lots of very emotionally charged questions that need answers.
But a lot of times you need a provider that’s working with you and like, can we fix your gut? Can we do things to
lower your TPO antibodies so that we can calm down the inflammation in your thyroid? So maybe some of it will work
again? And can you put Hashimoto’s into remission? You can. I think if you’ve listened to me, you’ve heard me say,
you know, my TPO antibody was super high and it’s gone into remission. So great questions. Again, Hashimoto’s is an
autoimmune process. Nodules are structural findings of your thyroid. They are growths in your thyroid. They may or
may not be related to the autoimmune process directly, and a thyroidectomy is usually a decision based on
structural, functional, comprehensive, like how suspicious or biopsy driven concerns we have from your thyroid
nodules. It’s not just your thyroid antibodies are high. You need your thyroid out. So if you ever go to somebody and
they say, oh, your thyroid antibodies are high, you need your thyroid out, you need to run away. Like that is not a
reason to have your thyroid out. Thyroidectomies are usually, again, they’re based on how likely these nodules can
either cause structural issues because they’re so large, they can compress your ability to swallow. We’re talking like
five centimeters, you guys. It’s not very common. Or how likely is it that that nodule is cancerous? And we can tell
that very well through biopsies.
So autoimmunity and thyroid structure are related to conversations, but they are not the exact same conversation.
Okay, so can nodules go away? So here’s the frustrating thing about nodules. And I’ve told people this as an
endocrinologist for ten years, a third of them remain stable, a third of them grow and a third of them get smaller. We
never know. It’s frustrating, but they’re either going to stay the same size, they’re going to get bigger or they’re
going to get smaller. Some need biopsies depending on the size and what they look like by ultrasound. They’re a very
good criteria. Some do become surgical conversations. Again, size of five centimeters or bigger if it’s causing you
issues swallowing. If the biopsy characteristics are highly concerning for cancer, we can give you an actual
percentage. I mean, I don’t want to promise anyone that you can reverse Hashimoto’s or reverse thyroid nodules.
There’s actually procedures now where they do ablation of nodules. And supposedly it’s supposed to make the nodule
shrink. Most of those have been shown that that they can, but not all of them. So again there’s no promise on
remission. But I will tell you that I think remission is one of those words that can be helpful or misleading, depending
on how it’s used. If by remission, we mean reducing immune activation, improving your symptoms, stabilizing your
labs, improving resilience, and helping someone feel better, then yes, that is often a very reasonable goal.
We do it all the time at Modern Endocrine. If by remission we mean there is never any future thyroid vulnerability
again, that is a much bigger promise than I am comfortable making. So although I am in remission and my TPO
antibodies are low and I’m doing well, that does not mean it’s going to happen forever if I don’t do my work. If I don’t
get my sleep and eat the way I’m supposed to, and exercise and take my thyroid medication and do all the things I’m
supposed to do, then my TPO antibodies will probably go back up and maybe I’ll get nodules again. So you have to
put in the work. Health is not owned, it’s rented, and the rent is due every single day. Now I want to tie in PCOS or
now PMO s poly endocrine metabolic syndrome here. This is when you have insulin resistance. It causes a lot of
inflammation. It causes a lot of hormonal shifts and hormonal issues. There is a stress physiology component with
this. There is a body composition issue because we have high insulin levels. A lot of times we’re gaining weight.
There’s a sleep component because our cortisol a lot of times is high and our insulin is high. Sometimes we are under
muscled when we have PCOS. Sometimes we’re not because our testosterone is high, but there’s a fight between
testosterone and insulin. And then there’s a blood sugar instability issue. Okay. Hashimoto’s and PCOS or PMOs often
travel with the same metabolic and inflammatory traffic.
This is why one woman may be told she has a thyroid problem. Another is told she has a hormone problem, and
another is told it’s stress. The truth is, it may be all of those systems talking to each other. A lot of times with
Hashimoto’s and with hormone issues, then you can actually have an overlap of that. And a lot of Hashimoto’s people
have PMOs or PCOS or insulin resistance. So when blood sugar and insulin are part of the picture, this conversation
changes even more. Which brings me to type one diabetes. I want to talk about that as well. People have asked, is
there a correlation between Hashimoto’s and type one? And so all of this kind of goes together too with thyroid
nodules and Hashimoto’s and remission. Again, can remission happen? It can. Can it happen forever. It’s not
guaranteed. And once you calm down, inflammation from Hashimoto’s by fixing your gut, by eating well, by doing
everything I talked about in my book, there’s a whole section in the back about these are the ten stages of ultimate
health. Once you calm that down, that’s great, but you have to live by it. And then a lot of times in that you will
unravel that maybe you have insulin issues, maybe you have Hashi’s and PCOS. And then also, you know, there may
be other autoimmune underlying things. And so I had a lot of questions too related to autoimmunity, PCOS, PCOS,
Hashimoto’s, and type one diabetes.
Like, oh my gosh, if I have insulin resistance and I have Hashimoto’s. Am I more likely to get type one diabetes? And
so that is a good question as well. And so somebody directly said, my question relates to type one diabetes and how
that changes your approach to healing. For example, intermittent fasting insulin resistance hormone therapy. Would
this change for a type one diabetic or would the same approach be taken? This is such an important question
because type one gets lumped into general metabolic conversations all the time, and it shouldn’t. Type one diabetes
is not the same as type two. It is not a pure insulin problem. It is an autoimmune problem. So sometimes it gets
lumped into Hashimoto’s as well. But but they’re very different because a lot of hashi’s people have insulin resistance
and PCOS type two type symptoms. However, I will also tell you that unfortunately, because obesity is such an
epidemic in this country, a lot of type ones are becoming insulin resistant and becoming obese. So it kind of depends
when you have type one, what profile you have. Are you really a true type one not insulin resistant or are you insulin
resistant? You cannot take advice meant for insulin resistance, weight loss, or PCOS and assume it applies the same
way to everyone with type one diabetes. So keep that in mind.
Fasting needs more caution if you have true type one diabetes, because yes, if you are taking a basal or a long acting
insulin, then fasting may not be right for you, at least not prolonged fasting. If you are insulin resistant or type two,
fasting can be right for you in a medical supervised setting. Blood sugar variability changes exercise planning when
you have type one versus type two. So you will have blood sugar swings that you’re going to have to think about.
Post workout glucose response is going to differ with type one versus Hashimoto’s. In type two, hormone therapy has
to be viewed through a glycemic response. When you have type one body, recomposition may require a more
individualized fueling strategy. When your body comp starts to change with type one muscle fat loss, etc., insulin
requirements change and also your calories needed for that to happen need to change as well. So you have to work
with a really good nutritionist and somebody who again zooms out and understands that type one diabetes and
insulin play with thyroid hormone, play with inflammation, play with sex hormones. The goal is not just fat loss or
symptom reduction. The goal is safety plus stability when you have type one diabetes. So I had a couple people ask
about this. Type one is not simply a more extreme version of insulin resistance. It is not. And I think that’s important
to know and to hear. It is a different physiologic reality.
And so the broader takeaway is individualization. And that’s what we do at modern endocrine. Everyone is
individualized. And so if you have type one we need to know are you insulin resistant or do you have a true just type
one profile and then if you also have thyroid disease or Hashimoto’s, we look always at your gut with diabetes. Oh my
gosh. If you have diabetes and you’re listening to this and you have no idea what’s going on in your gut, you need a
gut study. It will change your life. It will improve your blood sugar. Sometimes it will fix or improve your blood sugar
with type two as well. I’ve had people come off of diabetes medications by fixing their gut, but it’s an individualized
approach. What works for a woman with mild Hashimoto’s and stable energy may be totally wrong for somebody with
type one postpartum immune changes or significant medication sensitivity. So everyone’s different and type one is
very near and dear to my heart. I took care of hundreds of type one diabetics when I did general endocrinology, but
it’s different. So don’t lump yourself into the PCOS, insulin resistant type two. And that is really the theme of this
whole episode. I want you to stop assuming the body needs more, and I want you to stop assuming that you can
lump yourself into one big. You know, just everyone is the same. And I just want you to realize that oftentimes we all
need precision.
And that’s what we do at Modern Endocrine. We try to make sure that not everyone is lumped into one box that we
are looking at you. We’re zooming out, we’re looking at a whole. We’re looking at how your labs correlate with your
symptoms. And then we’re like, we’re like little detectives. We’re trying to figure out, okay, here are your labs, here
are your symptoms. Now, what are driving these symptoms that don’t make sense with this lab? Once we’ve figured
out, okay, what’s going on with your labs, and we started deploying things to make those labs better and optimal
based on the symptoms you have, if you come back and your labs are still not where we think they should be based
on what we’re giving you or the symptoms you’re having. We have to be a detective and figure out, okay, why are we
giving this person thyroid medication? And we’re giving them enough, but their T3 is not where it should be. Or why
are we giving them thyroid medication? And we know we’re giving them enough because their lab value shows that,
but they don’t feel it. What is going on? What is the disconnect here? So we have to figure that out. And we do a
wonderful job at Modern Endocrine with that. That’s how the basis of why I started this is we look at your cell
membranes. It always goes back to your cell membranes.
There’s inflammation. Where’s the inflammation coming from? Usually your gut, which is why we work. We look
there. Sometimes it’s micronutrients because the micronutrients can’t open the cell membrane door. Maybe it’s your
hormones. Maybe you just need to add more hormone. Or maybe we need to look at how the hormones metabolizing.
Maybe it’s your nutrition which is driving inflammation in your gut. Maybe it’s your hormone production. We’re not
making enough progesterone. So we need to add that maybe it’s that you’re never seeing the sunlight. And so your
melatonin and your circadian rhythm is off and it’s messing your sleep up. And once your sleep’s messed up, it’s
affecting your growth hormone, which affects your thyroid hormone, affects your insulin production, your cortisol.
Maybe it’s toxic relationships, you’re chronically stressed, somebody’s talking meanly to you, or you’re in a work
environment that’s not good. It’s affecting your gut. Now you have leaky gut. When you have leaky gut, you’ve
developed H pylori. Now your ferritin is low. You can’t convert your thyroid hormone. Oh, we’re not making T4 to T3
conversion in our gut because we’re chronically stressed. Our insulin is high because we have leaky gut. So it just
goes on and on and on. And if you don’t understand this, you’re not going to get better. Now talk about all that in my
book, fix your gut, fix Your hormones. There are dedicated chapters. There’s a PCOS chapter, there’s an infertility
chapter, there’s a thyroid chapter, there’s a menopause chapter.
There’s a put it all together chapter. There’s a ten stage ultimate health like I just told you chapter. So if you’re not
ready to work with somebody, great, at least get the book and know what labs you need. Get the book to know what
labs you need to. Ask your provider, what your lab values should really be. Ideally, again, you take that in context
with your symptoms. There’s a whole chapter that walks through a GI map. If you want to do a GI map on your own,
get the book. It’ll tell you exactly what is going on. Now, again, this all has to be put in context. And that’s the so
important thing that I need you guys to understand is no matter what question you have or no matter how I answer
it. And again, this is not medical advice because you’re not my patient, but this is general information and you should
always talk to your provider about you individually, your individuality, your labs, your symptoms. What is going on in
context is so important. And as long as you have a provider that understands this, they’re going to help you figure
out the best thing for you. It’s not rocket science, you guys. It’s just you have to step back and zoom out and figure
out what is going on. If you take one thing from this episode, let it be this. With Hashimoto’s, the goal is not to
outwork your body out, supplement your body or out.
Restrict your body. The goal is to understand what your body can currently tolerate, what it can recover from, and
what it can respond to. It’s also your job to make sure you have a provider that will look at your labs and correlate
those with your symptoms. If you don’t have somebody that you can talk to about zooming out and your labs and
your symptoms and who will look, you know, big picture at your gut and your sex hormones and your insulin and your
cortisol with your thyroid. You’re gonna have a problem putting all this together. So a four part kind of takeaway from
all your questions and what we’ve talked about. Number one, stabilize your medication plan with Hashimoto’s. Don’t
react to symptoms or labs in isolation. Make sure you’re looking at your labs with your symptoms and look at the full
clinical picture. Don’t be trying to change things every day. Find a provider to help you figure out what’s going on.
But again, you’ve got to stabilize your medication and maybe you need T3 three times a day. Maybe you need it
twice a day. Maybe you need it once a day. Everyone’s different, but your medication plan has to be stabilized. The
second thing I want you to take away from this is match exercise to recovery capacity. So many people are worried
about exercise and losing weight with hashi’s PCOS, inflammation walking is foundational.
I do it every day. Strength training is helpful but can be done 2 to 4 times a week at max. More is not automatically
better. There have been weeks in my life I have not done any strength training and walked and did yoga every day
because I just I wasn’t recovered and my adrenals could not tolerate it. And that is okay. Number three support
muscle and metabolism without overtaxing the system. Make sure you’re fueling your body. Make sure you’re
prioritizing protein. Make sure you’re prioritizing sleep, especially between the hours of 11 p.m. and 2 a.m. when our
growth hormone is made, you should not be awake after 10 p.m. you want to be asleep by 11 p.m.. So you make
growth hormone and you want to be asleep from 11 p.m. to 2 a.m. so that all your growth hormone is made and you
can make thyroid hormone better. Also, make sure that you’re prioritizing stress management and blood sugar
stability. All of these things will help support muscle and metabolism without overtaxing the system, which ultimately
helps you feel better and helps your Hashimoto’s. And the last thing is use labs in context. Please please please.
Antibodies fluctuate. Symptoms matter. One number is not the whole story. You do not need to destroy yourself in
the gym. Constantly chase labs or panic every time your body shifts. You need a smarter strategy, one that works
with your thyroid, not against it.
So I hope that all of that information was helpful. I wanted to answer the questions that you guys submitted. Keep
submitting them. If you liked this type of content and you thought this was helpful, share this with somebody who
needs to hear it. I know that there are patients that you know or friends that you know that have Hashimoto’s. Call
them patients. You have friends that you know, that have Hashimoto’s, that have thyroid issues that need to hear
this, share this episode with them so that they can get these questions answered. Please, wherever you listen to
podcasts, make sure you’re following us so that you get our episodes every week. I’m going to do more of these, and
I’m going to actually answer direct questions as well. So be watching on social media. I’m going to say, put your
questions here and I’m going to literally read them and answer them. I’m going to do a few episodes like that. If you
like this, let me know. Please leave a review for the podcast. The more reviews we get, the better that when people
are searching for answers like this, it’s going to push it to them. Also, if you have not got my book, Fix your Gut
Fixture Hormones, it’s on Amazon, but go to gut hormone fix.com. I have so many free things for you guys. I have a
whole section on Hashimoto’s there. The labs I just talked about, your reference guide.
What we do for Hashimoto’s, like go to gut hormone fix.com and get your free resource. My book is available on
Amazon. And if you’re ready to have a provider that takes all of this into account, that takes your gut into account,
that takes your symptoms, your labs, everything that’s going on, consider working with modern Endocrine. We have
a license in 46 states. We do telehealth. We do a phenomenal job. We look at your micronutrients, your cell
membranes, your gut, your hormones, everything that we talk about in the book, the ten stages, that’s what we do.
And you don’t have to be in Oklahoma City if you’re in Oklahoma City, we have a state of the art clinic, but anywhere
else, you are in 46 states, we do telehealth. You can book a discovery call at www.endocrine.com. Click on Become a
Patient. We would love to help you in your journey. And if you listen to this podcast, if you want to check out my
supplements shop.endocrine.com, use code. Listen ten. I will give you a discount for listening to this podcast. We
have great thyroid supplements. One of them is called Thyroid balance. I also have an iodine superior selenium
iodine. I have mighty methylfolate which is a methylated B vitamin. All of these are great for my thyroid Gurley’s
inositol if you have PCOS. So if this episode resonated with you, like I said, please send it to the woman who feels like
she’s doing everything right and still not seeing her body respond because chances are she doesn’t need more
discipline. She needs a better framework. I’ll see you on the next episode.