T2: The Thyroid Hormone You've Never Heard Of with Dr. Amie Hornaman

Summary

Better! with Dr. Stephanie – Episode Summary
Episode Title: T2: The Thyroid Hormone You’ve Never Heard Of with Dr. Amie Hornaman
Host: Dr. Stephanie Estima
Guest: Dr. Amie Hornaman ("The Thyroid Fixer")
Release Date: March 3, 2025

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Overview

This episode dives deep into thyroid health—particularly for women navigating perimenopause, menopause, or struggling with weight and energy issues. Dr. Stephanie Estima welcomes Dr. Amie Hornaman to demystify the thyroid’s role, evaluate standard versus optimal testing strategies, and, for the first time on this show, unpack the lesser-known thyroid hormone T2. The conversation balances rigorous science with accessible, actionable advice, including nutrition, lifestyle, and the strategic use of supplements for hormone optimization.

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Key Discussion Points & Insights

1. The Thyroid as the Master Gland

• What the Thyroid Does

  • Controls metabolism, hair growth, nail strength, brain energy, body temperature, heart rate, digestion, and more.
    • “The thyroid is the master gland... it runs the show.” (Dr. Amie, 04:05)
  • Low thyroid = "low and slow" – everything in the body slows down if thyroid function dips.

• Metabolism, Recovery, & Immune System

  • Thyroid function critical for energy, recovery from exercise, and immune health: “From a fitness perspective, [the thyroid] helps you recover from your workouts.” (Dr. Stephanie, 05:00)

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2. Thyroid Testing: Standard Care vs. Functional Approach

• Traditional Testing

  • Most conventional MDs test only TSH (a pituitary hormone, not a thyroid hormone) and sometimes Free T4.
    • “TSH is a pituitary hormone...when TSH is high, thyroid is low.” (Dr. Amie, 06:51)
  • High TSH is often treated with T4 medications (Synthroid/Levothyroxine) without full assessment.

• Functional/Optimal Testing

  • Should include:
    • TSH (optimal: <2, not just within the "normal" reference range)
    • Free T4 & Free T3 (the active hormone, optimal in the upper quadrant of reference range)
    • Reverse T3 (should be <12)
    • TPO & TG Antibodies (Hashimoto’s testing: optimal is ZERO antibodies)
  • “You have to look at your own labs if you’re not working with a functional practitioner.” (Dr. Amie, 12:52)
  • Many conversion problems (T4 to T3) are missed without comprehensive testing.

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3. Conversion Issues: Why Thyroid Symptoms Persist

• Where Conversion Happens (T4 → T3): Liver, gut, peripheral tissues, possibly skeletal muscle.
• Barriers to Conversion:
  • Insulin resistance, nutrient deficiencies (magnesium, selenium, iodine), estrogen dominance, high cortisol, toxin exposure, genetics.
  • Iodine is critical but controversial; “Just go nice and low and slow” in dosing. (Dr. Amie, 27:51)

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4. Diet & Lifestyle Factors Impacting Thyroid

• Iodine’s Role
  • Essential for thyroid hormone production and conversion; “Every cell in our body has a receptor for T3, also for iodine.” (Dr. Amie, 28:07)
  • Toxic halides (fluoride, bromide, chlorine) can block iodine’s access—water filtration is important.
• Soy & Cruciferous Veggies
  • Soy: Clearly impairs both thyroid function and medication effectiveness if consumed in large, regular quantities.
  • Cruciferous vegetables: Only an issue in excessive raw intake.
  • “Don’t be using soy protein, soy milk... very toxic to the thyroid.” (Dr. Amie, 36:52)
• Gluten & Autoimmunity
  • Gluten’s molecular mimicry can provoke or worsen autoimmune attacks on the thyroid.
  • "Every time you consume gluten, you’re going to have an autoimmune attack." (Dr. Amie, 72:15)

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5. T2: The Thyroid Hormone You’ve Never Heard Of

• What is T2? (L-Triiodothyronine, Diiodothyronine)
  • T2 is an active thyroid hormone, but has no standard lab assay yet for public clinical use.
  • Unlike T3 or T4, T2 works directly at the mitochondrial level—enhancing ATP production, basal metabolic rate, steady energy, and targeted fat loss (without muscle loss).
    • “T2 is an exercise mimetic... it leaves muscle alone and only targets body fat.” [Dr. Amie, 46:01]
• T2 in Bodybuilding & Beyond
  • Used in the bodybuilder community for years to preserve muscle mass while cutting fat.
  • No negative feedback on thyroid gland (doesn’t suppress natural production).
• Safety & Dosing
  • Human studies: 150-300mcg/day is safe and effective; no reported undesirable side effects at this dosing.
  • “Just use it responsibly, stay under 300mcg.” (Dr. Amie, 48:43)
• Supplement Forms
  • T2 is not available as a prescription drug, but is in specialist supplement lines (like Dr. Amie’s Fixer line).

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6. Perimenopause vs. "Thyroidpause" – Differentiating Symptoms

• Symptom Overlap
  • Many symptoms (hair loss, fatigue, weight gain, mood issues) overlap between menopause and hypothyroidism.
    • “My definition of thyroidpause is when your thyroid craps the bed after 40 due to fluctuating hormones.” (Dr. Amie, 63:57)
• Clinical Approach
  • Test both sex hormones and thyroid extensively. Both can—and often do—dysfunction together.

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7. Actionable Advice & Protocols

• Fundamental Supplements
  • “No duh” basics: Vitamin D, magnesium, iodine (low, slow dosing), essential amino acids, mineral support, liver support.
• Diet
  • Avoid sugar, seed oils, processed foods.
  • Strictly eliminate gluten if hypothyroid or Hashimoto’s.
• Exercise
  • Resistance training is essential; avoid chronic cardio. “It is so detrimental to a woman’s thyroid function... we have to stop being cardio queens.” (Dr. Amie, 76:41)
  • If you can’t lift heavy, work to muscle failure in whatever capacity you have.
    • “I’m asking for 45 minutes a couple times a week. You can do that.” (Dr. Stephanie, 79:18)
• Lifestyle
  • Address stress, prioritize sleep, manage insulin resistance.

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Notable Quotes & Memorable Moments

• “You have antibodies? You have 20 soldiers attacking your thyroid. So who made the 34 (cutoff)?... That’s silly to wait until someone has that little H or the little red.” (Dr. Amie, 19:08)
• “I don’t care if you don’t like it, you have to do it… It’s called being an adult.” (Dr. Stephanie, 76:53)

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Timestamps for Key Segments

• The basics of thyroid function: 04:04–06:45
• Standard vs. optimal thyroid testing: 06:46–13:28
• Functional lab ranges explained: 12:36–17:28
• Hashimoto’s & antibody controversies: 18:46–21:56
• Conversion issues, causes, and iodine: 24:04–31:25
• T2: Mechanisms and benefits: 40:58–47:45
• T2 dosing, safety, and application: 48:34–54:56
• Menopause, thyroid pause, differential diagnosis: 63:37–66:00
• Lifestyle, nutrition, and fitness protocols: 71:20–79:18

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Where to Find Dr. Amie & Resources

• Podcast: The Thyroid Fixer
• Website: doctoramie.com (Thyroid protocols, supplements, patient consults in US/Canada)
• Special Offer: Betterlifedoctor.com/betty (Code BETTY20 for supplement discount)

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Bottom Line:
Women over 40 or experiencing classic symptoms should advocate for comprehensive thyroid testing and take a functional, lifestyle-first approach—covering nutrition, resistance training, foundational supplementation, and thoughtful hormone support. Emerging evidence for T2 supplementation is promising, particularly for metabolic health, but should be used judiciously.

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For More:
Listen everywhere you get podcasts, and check show notes for detailed recommendations, further resources, and links to Dr. Amie’s offerings.

Transcript

[A]

When you are in that frustrating place where you're like, I'm doing all the things, the weight's not coming off, it just keeps going on. What do we do as women? We do more cardio and then we do it twice a day.

[B]

And the doctors tell us to do that, too. Eat less, move more. What do we think when we say move more? We think I should get on the treadmill and run.

[A]

Exactly, Exactly. It is so detrimental to a woman's body and to a woman's thyroid function that hands down, we have to stop being cardio queens.

[B]

It isn't about being perfect. It's about being better. Hello, My name is Dr. Stephanie Stima and I host expert discussions with thought leaders in all facets of health, including nutrition, fitness, hormones, stress management, performance recovery, longevity, healthspan and energy production. On this show, we discuss complex science, but then we also alchemize it into actionable everyday living. The ultimate goal with the show is to assist you in making informed decisions about your health and to catapult you into being the hero in your own life. Hello, Betty's. Welcome back to better with Dr. Stephanie tis me, your host as always, Dr. Stephanie Estima. I am joined today with Dr. Amy Horneman. She is known as the Thyroid Fixer. She is an expert in thyroid and hormone optimization. She's a doctor of clinical nutrition and a certified medical practitioner. She's also the founder for the Institute for Thyroid and Hormone Optimization and creator of the fixer supplement line. As you might have guessed, we are talking about thyroid function today. What the thyroid does, all of the thyroid hormones beyond your traditional TSH and T4, we talk about T3, reverse T3, we talk about T2. Stay tuned for that super interesting conversation on that along with iodine and gluten and minerals and all the things that we can be doing to optimize our thyroid, particularly in the perimenopodopathy menopausal years. Because we know that there can be a concurrent decline in sex hormones, certainly in perimenopause and menopause. And of course, there can be a decline in thyroid hormones as well. I loved this conversation. I know you are going to love it as well. And I want you to, as you're listening here, think about who else might enjoy this show. If you are enjoying the show, we always love and appreciate a recommendation or a star. If you're listening on Apple and if you feel so inclined to leave us a review on Spotify, it just helps more Bettys join the Betty army and the Bettyverse. So Please enjoy. And with a mind to share, please enjoy my conversation with Dr. Amy Corneman. Fueling my body with whole foods is important, but every diet has its nutrient gaps, including mine. That's why I always start my day with AG1. It ensures that I'm covering my nutritional bases and supporting my gut health. Something ladies that definitely declines in perimenopause. I trust AG1 because the entire formula is backed by research studies, not just the individual ingredients. In multiple studies, AG1 has shown to double the amount of healthy bacteria in the gut, including two species known for supporting gut health and whole body inflammation. If there's one product I trust to support my whole body, it's AG1. And that's why I've partnered with them for so long. It's easy and satisfying. To start your journey with AG1, try AG1 and get a free one year supply of vitamin D3 and K2 as well as five free AG1 travel packs with your first purchase at drinkag1.com Stephanie that's drinkag1.com forward slash. Stephanie. Dr. Amy, welcome to the Better Show. I'm thrilled to have you here today.

[A]

Oh my goodness. I'm so happy we finally connected and get to deep dive into all things thyroid.

[B]

Yeah, I've had people on the show talk about thyroid before, but as a primer, as a refresher, it's been a minute. Why don't we talk about just generally, what does the thyroid do? Why do we need to pay attention to this?

[A]

So the thyroid is the master gland. So you have to think of it at the very top of all other systems in your body. It runs the show. So it gives you a metabolism, it grows your hair, it strengthens your nails, it lights your brain up, it gives you energy to get through the day, it regulates your body temperature, it regulates your heart rate, it determines whether or not you poop every day. Because if your thyroid is low and slow, so I always say think hypothyroid, hypo, low and slow. Any system, any process in your body is going to slow down when your thyroid slows down. So you can see how important it is because it's regulating everything. And that that master gland really determines what, whether other systems in the body work and it really determines how you feel on a day to day basis.

[B]

Yeah. And I think when we're talking about the thyroid, I mean we'll get into, we're going to talk about all the hormones today as well. One of the things I like to try and explain to patients or whoever I'M speaking to is the main role of the thyroid is to promote metabolism, right? So this is like promoting, let's say, glucose uptake into the cell so that they can do their thing and create energy. And if you don't have the ability to take substrate up into the cell, then, as you mentioned, you're gonna feel like all the things that you like. It makes your hair grow. Well, your hair is not gonna grow. You're not gonna be able to thermoregulate. You're gonna feel cold all the time. Like, all of these different symptoms, signs and symptoms that we'll get into. But it's like the thyroid is responsible for, even from a fitness perspective, helping you recover from your workouts. I can't tell you how many women with Hashimoto's are like, I went into the gym, did live, and then I was. I was bedridden for three days, right? So that recovery process, that immune. That central tolerance, that kind of goes away. And that immune recovery also is impacted by the thyroid as well. So this is really an all, like you said, a master gland. It's all encompassing. Let's talk a little bit about the hormones that are involved, because we know that there's a. I'll call it a standard of care that we often see in the allopathic world. So, like traditional physicians who are just looking at certain hormones, and so many women, I think, yourself included, if I've done my research correctly, have had to literally go to doctor to doctor to doctor to try and get answers, even though people are saying your labs are normal. So let's talk about the hormones that are typically looked at in a. From a traditional MD So an allopathic physician. And then maybe let's expand that into what you really should be looking at in terms of the, you know, the full gamut of thyroid hormones.

[A]

And this is so, so important because you nailed it, Stephanie. As soon as you go to your doctor and you say, let's say you. You tell your doctor, hey, I'm having all of these symptoms that we just kind of rattled off. I have low metabolism, my hair's not growing, I'm really tired, I'm constipated, my brain's not functioning well. I would really like a thyroid panel. So you ask your conventional doc for that. And what you will receive is TSH and maybe a free T4. So we'll start with those two and break those down, and then we're going to go into what you actually need and what you should be asking for. So TSH is thyroid stimulating hormone. It is a pituitary hormone. It is not a thyroid hormone. And when we test that, it's. It's an okay test, meaning if TSH is elevated, if you're getting flagged high, then that means you have hypothyroidism. So the one thing to know about this test is it's one of the only lab markers out there where high means low. The higher that TSH goes, the lower your thyroid is actually functioning, because it's essentially your hypothalamus talking to your pituitary, which talks to your thyroid gland, and it's saying, hey, thyroid gland, you need to wake up here. You're not doing your job. You're not producing the thyroid hormones that you need to produce to help this person. So as TSH rises, it's basically yelling at the thyroid gland, do your job. Now, what if TSH is within those normal limits? What if it's even optimal per functional medicine standards? You can't stop there. You can't look at TSH and say, I'm sorry, Susie, you don't have a thyroid problem. No, that's unacceptable. You have to keep going. Now, conventional medicine will also test free T4. So T4 is one of the thyroid hormones produced by the thyroid gland, and it is inactive. So when we're looking at the whole slew of thyroid hormones, there's T1, T2, T3, T4, T1, and T4 on the bookends. Those are inactive. We can kind of push T1 aside. We don't even care about that. We'll push it aside. T4 is. This is where it comes in, the standard of care. So they look at your free T4, they look at your TSH. And then most conventional docs have been taught if TSH is above a 4.5 or whatever that cutoff is on your labs, then you give T4 medication. Levo, Synthroid, Tyrosen. You give T4, and that's enough. Well, then you say, well, wait a minute. Didn't you just say T4 is an inactive thyroid hormone? Yes. The body is supposed to take that inactive T4 thyroid hormone and convert it to become T3. T2 and T3 are both active. And by the. By the term active, I mean they get to your cell. So there's a receptor site on every single cell of your body for T3, not T4. Can't. Cannot attach to the cell, can't do its job, can't give you a better metabolism. It has to convert and become T3 in order to get to the cell like a lock and key. When that lock fits, when that key fits perfectly into the lock and turns, then boom, you have a metabolism. You're growing your hair, your. Your brain lights up. It has to become T3. So we have to test the active thyroid hormone. We have to test T3, and we want to test it in its free form so that. That free floating in your bloodstream ready to be taken up by the cell form. So we want to look at that free T3. Now, I mentioned T2. There's actually not an assay right now for T2. There's. We. We can test it when we're doing clinical trials, but there's not a public test for it. You can't go to Quest and LabCorp and request to test T2. But it is one of the active thyroid hormones that can also do a great job at increasing your metabolism. But when we're looking at testing, specifically what you're going to ask for from your doctor, you want to say, I want to go beyond TSH and free T4. I want to test my free T3, that active thyroid hormone. And then there's a few other tests that we threw in there as well, such as reverse T3 that actually tests to see are you converting that inactive thyroid hormone to be active or are you not really good at converting that. So we look at reverse T3, and then we always check for Hashimoto's by looking at the TPO and TGA antibodies. So in looking at all the thyroid hormones that the thyroid gland produces, we then can pair that up with the testing that really needs to be done to get that full picture of what's going on with your thyroid.

[B]

Great. Okay, so let's talk a little bit. Let's back up a little bit and give some values for people. So you mentioned Tsh 4.5 in my books. That's astronomical. That's way too high. What would be. And maybe we can contrast and compare. So maybe the. The little H that you see on.

[A]

The lab all the time. I love it like that.

[B]

You just like or like the red. You know, it's either like color coded in like red, yellow, green, or it's like H or L, like high or low or N normal. What would be something that you might typically see on a lab as air. I'm using air quotes for those of you listening normal. And then what is more of a tighter, we can say functional medicine or optimized range. In terms of what we would actually like to see, all the hormones that you just mentioned. So we can go TSH, free T4, free teeth. I'm assuming you don't look at total 4 or total 3, or maybe you do, or it's not important if you have the free level. So let's go through, let's go through TSH, free T4, free T3, what you might see on a typical lab and then maybe what an optimized range looks like.

[A]

Yes, yes, yes, yes. This is so important. And I love it when I talk to someone and they say something exactly how I always say it. So I love that. That's why I was laughing. I'm like, I always say that little H, that little H next to it.

[B]

Yeah.

[A]

So, right. We don't. You don't want to look at your labs and, and look for that little H, because that's all your doctor is doing. There's. They're doing a quick scan.

[B]

That's their interpretation, by the way. That's like they haven't looked at all the numbers. Like, how do all these things fit together? They're like, do I have an H or an L? That's it.

[A]

Yes, that's exactly what I said. You have an H or an L. So you have to look at your own labs. If you're not working with a functional practitioner, you have to look at it through a functional lens. So let's give you those functional lab values. So TSH, I like it below a 2. And I have no problem if someone is on thyroid hormone replacement and let's say they're taking natural desiccated thyroid or anything with T3 or we have lyothyrenate on board, we know that that TSH is going to go down. So I personally, I don't even freak out if it goes below a 1, below a 0.5. It all depends on that person and what their doing to treat their thyroid. But in general, we want that TSH to be below a 2. Free T4 I honestly don't care about because it's just one little piece of the puzzle. And what I found over the years is when I give an optimal T free T4, people tend to chase that. And in chasing that, they might continue to increase their teeth for a medication which then can increase the reverse T3. So you always have to look at that free T4 and the reverse T3 together. Because if someone has, let's say, a free T4 of 1.5 and we say, oh my gosh, well, that looks great. It's, it's within that normal range. It's Actually, a little bit closer to the top. Isn't that a good thing? I go, it's only a good thing if you're converting your T4 properly over into T3. It's a bad thing if your doctor keeps increasing your dose of T4. Oh, Cindy, you're on 88. Let's take you to 112. Let's take you to 125. Let's take you to 200. And no one is checking your conversion. So free T4, I would say you just kind of. You glance at, set it aside, come back to it, until you look at those other important lab values. Two most important ones. Free T3, like we mentioned, it's the active. I like that in the upper quadrant of the range. And I say upper quadrant because it depends what lab you're using, what country you're in. Those lab ranges can shift and change even in the US from LabCorp to Quest. They're just a little bit different. So if you take that standard lab value range and you cut it into four, we want you in that upper quadrant or even a little bit over. I have no problem. If you get a little horrible with your free T3 and you tell me, I feel fantastic, then I'm going to look at that and go, okay, that's great. Then that's your optimal for free T3. Then we move to reverse T3. That's checking your conversion. So that's checking. How well do you convert T4 to T3? And let me just throw in here that conversion process, although it is supposed to be very natural, it is built into our body. There are so many things that can impair it. I always say conversion of T4 to T3 for your body is like running 10 tough monitors in a row. There's a lot that can get in the way, and especially these days. The toxin exposure that we have these days, estrogen dominance, insulin resistance, which is out the wazoo across our country with the obesity epidemic, lack of nutrients, magnesium, low vitamin D, low selenium, low iodine. There are genetic snips now that we're finding that can impair T4 to T3 conversion. So this is why I drive the point home. You must test reverse T3 every single time that you get tested. Now, reverse T3 is not a bad thing. It's built into our bodies as a survival mechanism. So if you were in a car crash, if you were injured, if you were traumatized and you're fighting for your life, you. You're fighting for your life lying in the ICU we're going to test your reverse C3, and it's going to be through the roof. And thank God it is, because it's your body saying, listen, Steph, as you're lying here, you need to focus all of your energy at healing and surviving. You don't need to lose weight. You don't need to make major decisions. You don't even need to go to the bathroom right now. You need to lie there and survive and heal. The problem is that reverse T3 is elevated. As we're living life day to day and trying to get through our day and run a business and have a family and do all the things, it's putting our body in survival mode. It's telling our body, you don't need to lose weight, you don't need to think, you don't need to have energy. And you're like, you don't need to.

[B]

Go to the bathroom. Yes, I do.

[A]

I would really.

[B]

You don't need hair. No.

[A]

You don't need that either, right?

[B]

Yeah.

[A]

So we want to test that reverse T3 every single time, and that we want 12 or less. And I find this is pretty universal. The only lab that I've seen working with patients, really, in so many different countries, the only country that has a little bit of A wonky reverse T3 lab value is Mexico. And then you just kind of have to look at it and go, okay, what's around the halfway mark? I want to be under that halfway mark of the lab value range. But for most of us, it's. It's 12 or less. And then we move into the antibodies. So there are two antibodies that we test to see if you have Hashimoto's TPO thyroperoxidase or TG thyroglobulin, and those we want at zero. So I'm gonna expand just really briefly on this because I've even seen this in the functional and integrative space where patients have come to me after seeing another functional doctor who maybe didn't specialize in the thyroid. So they're just kind of going on basic knowledge, and they're looking at the labs and they're saying, well, you're. You're. You're at a 20, but the cutoff here is less than 34. So therefore, you don't have Hashimoto's.

[B]

And I go, well, wait, wait, but you have antibodies.

[A]

Wait, right? You have antibodies, right? You have 20 soldiers, I. E. Antibodies attacking your thyroid. So who made the 34? So we're going to wait until you have 35 antibodies to officially diagnose you with Hashimoto's. Meanwhile, between having 20 antibodies when we discovered it and 35 antibodies where you get diagnosed, you might gain an extra £20. You might have lost your job because you can't think anymore. Like, that's silly to wait until someone has that little H or the little red.

[B]

Right, Right.

[A]

Let's roll that back.

[B]

Roll that back. How. Like, how that does. That's nonsensical to me. And it's also, dare I say it, It's a. It's a little bit like gaslighting. It's like, there's nothing wrong with you. You know, it's only. It's only when you get to 34 that there's a problem. But you're at 24, so I don't know what you're complaining about. Like, just go and live your life. Like, it's a little bit like it's all in your head. It's that sort of all in your head, suck it up, buttercup kind of attitude. And of course, we know with autoimmunity in general, but certainly with Hashimoto's thyroiditis, men get it. But the vast majority of individuals with Hashimoto's are women. And that's never happened in the medical system before where women have been told that their symptoms don't matter and that they're not. Like, that's never happened.

[A]

Right?

[B]

I mean, that's not been your experience, has it? This is. This is sarcasm, by the way, in case it's. In case it's not completely obvious, right? Shut up. Like, 20 is not a problem. Zero is not a problem. Anything more than zero. It's like, how much mercury would you like in your body? You know, I'd like zero. I'd like zero in my body. How much lead would you. I'd like zero. Zero would be fine. Anything more than that, I have a problem with. The same is true for antibodies. I want zero of those. I don't want my body. I don't want my body attacking itself.

[A]

No, no, that's never good. That's never good. And medical gaslighting is huge. I mean, I experienced it 25 years ago. I heard all of those things, everything that you just said, that it's all in your head. It's not a big deal. I was told to eat less and exercise more, the whole thing. And I still hear that from my patients today, who are still hearing it from their doctors today, 25 years later.

[B]

I hear it from my community every week in Our support email. We have women, they're like, my doctor is refusing to run because we have a lab guide that we have. And it's like, you know, in there it's like, look for the tp, look for all the antibodies. And it's like they don't. And in part, it's, I think that it's changing. And this is not just a poo poo on the mds. Okay? We love mds. I have many friends who are friends, like mds who are friends. But I'll say that unfortunately the standard of care, like their prescribing ability doesn't change. Like whether or not you have a TPO or thyroglobulin. Like, they, they're still just gonna give you Synthroid. Like, they're, they're not, you know, like what they're going to do isn't going to change. So in some ways they don't actually care whether or not you have those or not. It doesn't change their approach to the. Like, they, they just have, like the script. Like, they just have the script for level. They just have the script.

[A]

Well, what's really interesting too is that's what they've learned. So years ago, I gave a talk to a group of integrative wellness doctors and they wanted me to come in and deep dive on the thyroid. So I was talking about the Importance of reverse T3 testing and why we do that. Like, we just went over and then I talked about the standard of care. I called it the Synthroid box. Why are you in the Synthroid box? And I said, it's interesting. If someone comes in with depression, you'll give them an antidepressant. If that one doesn't work, you're going to give them another one. And if that one doesn't work, you're going to tag on Abilify or some benzo and you'll keep stacking until you make them feel better. But someone comes in with a thyroid problem and you give them one medication when there are plenty of others out there in different combinations that we can personalize for that patient. Why is that? And the one doctor raises his hand and goes, that's all we've learned. So literally, it's like you can fault them but not. Yes, that is all they've learned in medical school. And I think that's a shame. But then after you get out and you're on your start branching out and learning more. And kudos to that group for wanting to learn more. But that's rare. Most people fall into Most docs fall into the standard of care and they do what they've learned and that is it.

[B]

And in some cases, Synthroid is a lifesaver. Right. Like, if you truly are not producing enough T4 and assuming, like you said, that you can do the 10 tough mudders and you can convert the T4 to three, maybe it is just a supply issue. Right. So that does work in a small subset of the thyroid. You know, on the thyroid issue on the spectrum. Right. Maybe we can talk a little bit. You brought, you mentioned it, but I thought maybe we can double click on it. What. So my understanding, and you can expand on this certainly is that about 60% of our T4 is converted in the liver to T3. But there's there's other, like you said, there's 10 tough mudders that someone might need to. Like, what are some of the conversion issues? Let's say whether it's in the liver. And you mentioned insulin resistance, so that makes a lot of sense. But what, what are some of the reasons why there might be a conversion issue from 4 inactive 4 to active T3?

[A]

Right, right, right. So when we look at where is T4 converted, like you said, the liver is one, the gut, peripheral tissues, and even the thyroid gland itself. So that opens up a whole other discussion for thyroidectomy patients. I always.

[B]

Muscle as well. Do you see it in the muscles? Conversion in the muscles?

[A]

That's a great question. Not that I. Well, they kind of lump it into peripheral tissue. So I would have to dig deeper into that to see if, if the muscles are one, because. Oh, I'm gonna look at that. Because if it is, that uplevels our discussion on how important it is to keep your muscle on and how it really is the organ of longevity. But I'm not sure about that. But when we're talking about conversion, so it. T4 to T3 conversion happens in all those locations, including the thyroid gland. So if you don't have a thyroid gland that just removed one place of conversion, so that kind of increases your chances of not converting properly. But when we look at all of the factors that come in, there's so many factors, like we mentioned, okay, insulin resistance, estrogen dominance is interesting because I get this question a lot from women who say, well, if I go on VHRT therapy and I'm taking estrogen, is that going to affect my thyroid? So it's important to, to unpack that. No, actually hormones and having proper levels of hormones, progesterone, estrogen, testosterone, very protective of the thyroid, actually Protective of autoimmune as well. Turning on. So that's one reason why women get more autoimmune than men, because men have more testosterone is very protective when we're looking at that estrogen dominance. Yes. As a menopausal woman, we know even as you're moving from perimenopause to menopause, your estrogen can kind of be on a roller coaster. We could test you one day and you are estrogen dominant and we test you two days later and then you're not. You have zero estradiol. So you're kind of on a roller coaster. But those little bursts of estrogen, that's not going to impair T4 to T3 conversion. But if you're walking around in that estrogen dominant state, and this happens a lot more in perimenopause where your progesterone tanks first but you're still making adequate estrogen. Now that estrogen, total estrogen or even estradiol is not necessarily going to be flagged high on your lab. But because you're low in progesterone and progesterone in immensely helps with T4 to T3 conversion, it is such a, it's such a beautiful helper with conversion. Now you are in a low progesterone, estrogen dominant state and that's going to impair things. Nutrient deficiencies. Magnesium. Iodine is the big one. And I know iodine is really controversial in our world.

[B]

Yes. Have questions about iodine. Yes, I'm glad you brought it up. Yeah, yeah.

[A]

So controversial. So now's the time to talk about it because it's imperative for, for lowering reverse T3 and improving conversion. Sometimes just giving someone iodine alone who has elevated reverse T3 and, and doing it properly, going nice and slow with the iodine so you don't make that person hyperthyroid or you don't send yourself into a thyroid storm doing it properly, that can even help lower reverse T3 and improve your T4 to T3 conversion. Iodine, iodine is hugely controversial because there were groups of physicians who use iodine on thyroid patients, but they started too high. They started at 25 and 50 milligrams a day. And that's a really high dose to start someone on. Now that's not a high dose on my face.

[B]

I was like, lots a lot. Yeah.

[A]

And so what that's going to do, what that is going to do is send someone possibly into a thyroid storm. And on the lower end of things, it's just going to make them Hyper for that day or two, you know, where they're just going to be like, no, I don't feel good. My heart's racing. I'm anxious, I'm jittery, I'm sweaty. I can't sleep. Right, because that iodine just bumped up your thyroid and kind of pushed you a little bit hyper. But if we just go nice and low and slow. So if we look at. Again, look back at the cell, what does the cell need? Every cell in our body has a receptor site on it for T3, also for iodine. And iodine, really, I mean, it assists the body in so many things because it is antiviral, antifungal. It helps with our immune system. I mean, anytime I think I'm getting sick, I slam down some iodine. It helps with energy. It helps with T4 to T3 conversion. It helps your thyroid gland itself produce adequate amounts of thyroid hormone. And when you really look at Dr. David Brownstein's work, who I think is the guru in iodine, when you. When you look at his work and just apply common sense to that work, you say, well, wait a minute, it just makes sense. Why wouldn't we take iodine if it's helping protect us from cancer? It's antiviral. It helps the thyroid gland. Why wouldn't we just take it? But in the correct amounts?

[B]

So you said 25 to 50 mgs a day. What is the. Like. I was thinking micrograms. But what is. What is like, an optimal level for iodine? Because I think on the. Like, you can sort of ride that area under the curve as well, where you're like, I'm getting benefit, I'm getting benefit, I'm getting benefit. And then you can overdo the iodine, like you were saying. And then I think on the other end of that AUC, you're gonna also see you're gonna run into T4 to T3 conversion issues with too much iodine as well.

[A]

Yeah, yeah, you nailed it. Exactly. So I always train my patients when you're starting off with iodine, and I love using liquid because you can titrate up nice and slow. Like, you can literally go up by one drop at a time. So the. The RDA for iodine, you're always going to see in micrograms. You're correct. When we look at Brownstein's work, he has used up to 100 milligrams with cancer patients. So he has a variety of stories of 50-100mg being used in cancer patients. Because, again, the other thing with iodine is that on the periodic table you look at it is right next to the toxicalides, and it's kind of part of that family. So fluoride, chlorine, bromide. When we don't have enough iodine attaching to our receptor sites on the cell, it allows for those toxic halides to attach instead. And all of those halides are not only toxic to your body, incredibly toxic to your thyroid, incredibly toxic. That's why no fluoride toothpaste. Bromide is tough because we're exposed to it everywhere.

[B]

I mean, where do you find bromide like fluoride? I get. It's like you natural toothpaste, swish with coconut oil, all the tongue scraping, all this. But where, how do you avoid bromide?

[A]

It's tough. And that's where it's like, sometimes you just have to support your body to be able to detox from the bromide. It's in our clothes, our furniture, our carpets. It's sprayed on lawns. If you live near a golf course, you're being exposed to that every day. Every time you golf, you are literally walking and breathing in bromide.

[B]

Is that anti weed? Is that like anti weed stuff? Like where? Like, what is it in the glyphosate? Like, what is it?

[A]

It's. It's in the. Whatever they spray on the. It's. It's notorious on golf courses. I don't know what they do to like, maybe green the grass more or keep out the weeds or something, but it's notorious on golf courses. It's really hard to avoid. So at that point, and again, even like chlorine, and it's in our water. So unless you have a reverse osmosis whole house water filtration system, you're getting exposed to chlorine and you just have to almost go, you know, there's only so much I can do in my world and afford to do. Why not just take iodine to try to help my body detox from that? So even when people start taking iodine, sometimes they can get a hertz reaction because their body is purging those toxic halides that have attached to their cells for so many years.

[B]

I have to say, one of the most important, I'll call it luxuries, because I recognize that it's a privilege to do this is getting a whole home water filtration system. I mean, I live in a city, all cities, most cities have hard water, and I would literally have to clean out. This is kind of gross. But like, that My hair would be like clogging up the damn drain. Yeah. And literally I got my home, like no affiliation, no whatever from Home Depot. Like they have a really great program there. It's like I put salt, like they installed it. You know, I get salt for, I don't know what it is, like eight bucks every like quarter and it's salt. I have salt water. My hair started growing back, stopped falling out. And of course, like, it's everywhere. It's in my sinks. It's, you know, the sink that I brush my teeth in. So I'm not getting the, the chlorine and the what, all the stuff that, the chloride and all the stuff that, that they put in the, in the water. But it is so worth it. Like I, it's one of the, it's one of those purchases that you don't see it. Like you don't, you can't see the thing. Right. But it's making such a holistic and systemic effect on your overall health and well being. Like, I highly recommend it. And everyone's got a Home Depot near them somewhere. So check it out there if you want more information.

[A]

Yeah, yeah, no, I second that. But no, for, just to answer your question on testing for iodine, there's a lot of controversy with that too. So what I find with my patients, if they're not taking it, we're going to test via blood. It's going to be low. If they start taking it, we're going to test via blood, it's going to be high. A couple of years ago, I interviewed an expert on htma, hair mineral analysis testing.

[B]

Yeah.

[A]

And I said, well, do you have iodine in your, in your test protocol? Do you test for that? He goes, no, because every cell in the body needs iodine, so there's no point to test it. Why don't you just take it? And that, that quote just has stuck with me through the years to where I went, oh, that's a really good idea because everyone's talking about, well, you put it on your skin and see if it absorbs. Oh, no, you have to do a, a loading test of iodine and then catch your urine for 24 hours. And it's like, instead of going through all of that, just take it because your body is going to know. So going back to what you said about, okay, you take it, you feel good, you feel good, you feel good, you take too much and then, ooh, it's backfiring. So you just go up nice and slow. You just start with one drop, two Drops, little bit of water. How do you feel? Okay. The next day or two, go up to three drops and you, you go up slowly and you assess and you listen to your body because your body is going to give you the signal when you have gone one or two drops too high. That's when you're gonna be like, oh, no, no, I feel anxious. I feel jittery. I feel amped up. Almost like you drank too much coffee. And that way you're catching it. Before you truly go hyper. You're just kind of hyper for that day. Not a big deal. Now, you know, go back to your last dose of iodine so you can really find your sweet spot on your own by listening to your body.

[B]

Great. What about. I've heard some people talk about cruciferous vegetables. I don't like to demonize any food, but talk to us a little bit about cruciferous vegetables. Is there a possibility or a link there that is interfering with conversion from T4 to 3? Does it matter if it's raw versus cooked? Does it ma. Like, tell us a little bit about that. If there is anything there at all.

[A]

So cruciferous vegetables have something in them called a goitrogen. They're goitrogenic, but really in their raw form. So they only are a problem if you are, for some reason, eating a boatload of raw broccoli, raw cauliflower. I don't think anybody eats raw Brussels sprouts or cabbage. But if you are, it's in that raw form in abundance. So if you're just. If you're using these veggies and you're putting them in a stir fry and you're cooking them or steaming them and you have them just a couple times a week, not a problem. The big. The big food that I tell people to stay away from is soy. Don't get. If you want to use some soy sauce or munch on some edamame, that's fine. But don't be using soy protein soy milk for any vegans out there. Gosh. The fake meat with all the soy, that is very toxic to the thyroid. So I would say avoid the soy products over the occasional cruciferous vegetable.

[B]

Why is it. Why is it toxic to the thyroid?

[A]

I don't know the actual mechanism. It is just widely known that it interferes with thyroid function big time. And it even interferes with, if you're on thyroid hormone replacement, the effectiveness and the absorption of that thyroid medication.

[B]

Okay, so do we know that it's. Does it. Is it affecting the conversion? Again, Is it the conversion of T4 to T3, or. We're not sure.

[A]

It's affecting the conversion and the production. So even people who are not on thyroid medication, they've never been diagnosed. And I actually saw this in one of my patients years ago, who they were eating a boatload of, you know, when. When the soy thing came out. I mean, gosh, I think this is. Back in, like, the tempeh and the.

[B]

Tofu and all that, everybody was kind.

[A]

Of, soy, soy, soy protein, soy, this. And she brought me her labs, obviously, comparison, like, well, these were last year, and this is right now. And just. Even the tsh, which we don't always look at, but when it's screaming at us, we look at it. Her TSH was something from, like, a nice little, like, 1.5, 1.7 to 25. And she had all the symptoms. And I'm like, what happened here? Maybe. Maybe Hashimoto's all of a sudden turned on. But when we really dove into her diet and lifestyle, she was kind of, you know, walking the vegetarian line, trying to do more soy stuff. And I was like, I think this is it. I think this is the culprit. So we pulled her back from that and retested, and TSH came down, and we did some other supportive supplements and nutrients. So she didn't even need thyroid medication. She just needed to change what she was putting in her mouth. And that improved her thyroid function.

[B]

Yeah. And I think sometimes it's just a matter of, like, you know, to your point, you mentioned before, like, with the iodine, like, you know, it's like a dosing issue. Right. So it's not that you can't ever have soy. Like you were saying, you can have edamame and you can have soy sauce, but if you're having maybe soy products several times a day every single day, maybe that becomes, you know, an overloaded stimulus that the thyroid is now not able to produce. Like you were saying, the. The T4 or T3, or convert 4 to 3 in the periphery.

[A]

Exactly.

[B]

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[A]

Yes, yes, yes. I love T2. So research has been out on T2 for 30 years, which is why it blows my mind that we're not hearing more about it. So research for 30 years. I have been researching it for about 15 years. So my first exposure to it was around 15, 20 years ago in the bodybuilding space because it was only present in like the Bro Science formulas, the, the products that are really geared toward bodybuilders and powerlifters. You know, those sarms and the angry names. Right. Like, and it is funny, to your point, I do joke that bodybuilders are the OGs of biohacking because they slash creatine.

[B]

Where do creatine come from? Right. It's like we. Yeah, it's just like it's the. It's the orange bros at the gym, screaming at the weights.

[A]

Oh, yeah, we were using creatine, gosh, back in the 90s and, and now we're seeing it come for, come out in, in the world for menopausal women and all the benefits. So it is, it's crazy, but 15 years of research that I've been doing on T2 and it is fascinating. So first of all, it is a thyroid hormone, like we said. However, the really interesting component to it is when you take does not act on the thyroid gland itself. So when we take T4 and T3, we have the natural normal feedback loop that occurs when we take any hormone, where we take the hormone and then it sends a message back to the hypothalamus and pituitary saying, hey, there's enough hormone in the system, you can stop telling the thyroid gland to make hormone. Or if you're taking testosterone, you get that negative feedback loop so you stop producing your own. And nine times out of 10, that's fine because your body isn't producing enough of its own anyway. So that's why we replace hormones. But the fascinating thing about T2 is it does not have that negative feedback loop on the system to where if you take it, it's going to shut down your own thyroid glands, natural production of thyroid hormones. So it doesn't do that. It works at the mitochondrial level. So in doing that, it's going to increase ATP production. So number one, it's going to make you have really nice steady energy through the day. Not a stimulant energy, not a fat burner energy from back in the day where we took fat burners and thought we were having heart attacks. No cardiovascular effect, no stimulating effect. Since it's working at the mitochondria, it just produces that smooth energy, steady energy through the day. But that's not even the best part. The best part is that it increases your basal metabolic rate. So it's increasing the amount of fat that you are burning at rest, increasing thermogenesis. And it does this in a couple different ways. One of the mechanism of action is that it browns white adipose tissue. So, you know, we're all jumping into cold plunges to, to stimulate our metabolism. But what cold plunging does is it literally browns that white adipose tissues, the white squishy adipose tissue that we grab. We're like, I don't want this on my body anymore. Or the white adipose tissue that's encompassing our organs, that visceral fat we ultimately want to turn it brown. And when you say brown adipose tissue, people go, I don't want any adipose tissue.

[B]

What?

[A]

Why do I want to turn it brown? Because in turning it brown, it becomes more metabolically active. That fat becomes full of mitochondria and it actually helps us with insulin resistance, it helps us with thermogenesis. So we want to brown that white adipose tissue. The other thing that T2 works on is stimulates mitochondrial uncoupling. And when we do that, we activate thermogenesis. Thermogenesis, the burning of stored body fat. So as you increase your resting metabolic rate, your rmr, bmr, basal metabolic rate, resting metabolic rate, you're burning more calories at rest and you are inducing thermogenesis. That, that heat, that burn, that taps into our fat stores and burns them for fuel. The other really interesting thing about T2, and this comes back to the interview that I told you about that I saw years ago, this is an interview of one of the trainers to the professional athletes in the bodybuilding fitness and figure world. So he is training these top level competitors to get on stage at their, their best self, the most muscular yet most lean self possible. And he says, I don't let my. You, I don't let my athletes use T3. Now, side note to that, why am I saying that? Because in addition to bodybuilders being the OGs of biohacking, they also experiment on themselves, sometimes to the negative. And yes, it's widely known when I was competing, many people would use T3 to burn body fat, regardless of whether they had a thyroid problem or not. They would just add it in because T3 does stimulate the metabolism, so it helped them burn more body fat. He says, I don't let my athletes use T3 because number one, T3 does not differentiate between burning body fat and burning muscle. It is going to burn both. So you have these athletes that have busted their butts for 12, 16 weeks trying to keep on all the muscle that they busted their butts for for the last nine months trying to keep on their body and build, and now you're going to take something that burns that muscle off. Yeah, it's going to burn body fat too, but you're going to burn your muscle. He said, the other thing is they're going to come out the other side of this show with a thyroid problem. And I think you and I have both seen especially the girls after a show and they look gorgeous before they're stepping on stage and you see them two weeks later walking on the treadmill, they are 30 pounds heavier. And because, number one, their body just rebounded from that strict dieting, and number two, they've given themsel a thyroid problem. So now they have no metabolism left whatsoever because of using and abusing T3. He says, I give them T2. And when I dove into the research on T2, I'm like, oh my gosh, he's right. It will only target body fat. It leaves muscle alone. So we actually can say that T2 is an exercise mimetic because when we look at what exercise does, it burns body fat, it increases our thermogenesis, it builds lean muscle tissue, improves insulin resistance, improves our lipid profile, improves fatty liver disease. And then we flip over to T2 and we go, oh, look, T2 does all of that as well. So it acts like an exercise magnetic while leaving muscle alone and only targeting body fat.

[B]

So why. Okay, so I have several questions about this. So whenever we think of sort of the intelligence of the body, we have T3. And as we've talked about, there's this feedback loop. We have this mirror in reverse, T3, where like you said, if there's an accident or we don't want to be really concerned about metabolism, there's this sort of break, right? There's like this inactive or mirror form of T3 that we call reverse T3 that we've been talking about. Is there an equivalent with T2? Like, do we have like a reverse T2? And is there any way that we can. You know, you talked about it as an exercise mimetic, but exercise, just like exercise, you can overdo exercise. So is there sort of an area, again, same kind of question, area under the curve, where we can sort of maximally profit from some of the benefits that you're talking about with T2, but is there a point where we can overdo it?

[A]

That's a great question. So I always go back to the literature and when I look at the dosing that they used in the human studies. So we have some on rats. That's great. That's where they started. They moved on to humans. In the human studies, this is where we found an average of a 9 pound weight loss in 28 days and an average of 4% body fat reduction in 28 days. Now that's the average. Remember, some are much lower, a few people are higher. The dose they were using was between 150 and 300 micrograms. So I always tell people, just state, we know that 300 micrograms is safe. I have not seen Any studies done above that. And the interesting thing, when I look at the literature, there are no, no undesirable side effects. And that's literally a quote from one of the studies. No undesirable side effects. So it does not affect the cardiovascular system. It doesn't have that negative feedback loop on the thyroid. Now again, I've not seen anything that said, hey, let's use 800 micrograms and see what happens. I don't know if there would be side effects there, but just in the use of T2, just use it. Respect responsibly, stay under 300 micrograms. So when I put those into my products, because I'd studied it for so long, I'm like, I need to bring this to the masses. I can no longer tell a 40 year old woman to go buy a bottle of something that has an angry gorilla on it.

[B]

Like she, I know, Massive gains with.

[A]

A Z. Gorilla cannibals. And you know, I mean, it was just crazy.

[B]

Yeah, yeah, yeah.

[A]

I think the product was actually called like cannibal claw or whatever. So I, I'm like, okay, I need, I need to, can we just feminine.

[B]

Can we make this a little bit gentler for like the women?

[A]

A little bit.

[B]

Just. Yeah.

[A]

So I knew when I put it into my products, I, I capped it at 150 micrograms for a serving. And I get this question all the time. Like, so I put in thyroid fixer, metabolism fixer, and I get this question, well, can I take both? And I say you can take one serving of each, but not higher than that. Cause then you're going over that 300 microgram and we just don't know. We just don't know.

[B]

So can you speak a little bit? I mean, I'm so fascinated by this because this is, I mean very transparently in school I didn't learn about T2 like I learned about T2 from you, you know, like I learned about T4 and T3. And then even just in my own like integrative functional medicine journey, it's like. And Then also reverse T3 and all the thyroid. And like that wasn't taught to me in sort of the standard curriculum either. Where are you mentioned with T3? Let's say that there are receptors all through the body. Same with iodine. Do we see the same thing with T2? It's like there's a T2 receptor. Where is the main activity? Like you mentioned the fat and there's like mitochondrial uncoupling. Is it that the receptor is on the, on the adipocyte. Like, where is, where is the main activity for T2 skeletal muscle?

[A]

It's. It's working at this. It. So it's more skeletal muscle mitochondrial uncoupling. So it's working at the mitochondrial level, but it's working on the skeletal muscle. And that's what makes it just so fascinating. And to your point, why don't we hear about it? Yeah, I think this is just the theory. I think it's because it is not in pharmaceutical form. It's still. And, and, you know, kind of like crossing fingers. Thank God, because that's the last thing we want is for big Farmer to get a hold of it. Now you have to go beg your doctor for T2. Like you have to try to beg and plead your dog. Hey, can we please use something other than this? T4 inactive thyroid hormone. So it's nice right now that they don't have a lock on it, but in the pharmaceutical industry not having it as a prescribed drug, we also don't get the amount of testing. So the testing and the, and the research that is out there, I'm actually impressed with thus far because you can't tie that to a drug and push a drug with the studies that are out on it. So that's, that's my theory as to why we don't hear enough about it. But 30 years of research, it's like, why is this.

[B]

Yeah, yeah, yeah. What. What sort of dosing protocol? Like, is there a cyclical nature to it? Sometimes we, like, for example, with perimenopausal women still cycling, it's often progesterone is like, There's a couple different ways to do it, but one of the ways is progesterone in luteal phase. Like day, you know, 12 to 14 to, you know, when you're, whenever your period starts. Do we need. What's the question I'm trying to ask here? Sensitization to the. Like, do we need to help keep the T2 receptor on the myocyte, like on the surface of the skeletal tissue sensitive? So do we go on and off it? Like, what. How would, how would we think about dosing it?

[A]

Have not seen any literature backing that one way or another with needing to cycle it. But I just think that's a good idea in general. I mean, that's, that's kind of what I tend to do with supplements anyways, is bring them in and then maybe take a little break and then bring them back in and take a little break. So there's no definitive schedule where we say, you know, make sure you take this for six weeks on and six weeks off. It's more, you know, go ahead and take it. Maybe if you're taking it for fat loss, get to your goal weight. And then as I shared with you how I use it, now that I'm, I'm, I'm at my goal weight, I don't need to lose more body fat. But let's say it's the holidays, we're going on vacation, you know, and you just start to see that scale and clothes get tighter, scale starts floating up. That's when I will bring it back in. Maybe I'll bring it back in proactively and then run it for maybe a month, six weeks, and then take it back out again and then float at my weight. So it really depends on personal goals and how you want to bring it in and out of your life. But I think if you had to use it, let's say you had 10, 20 pounds to lose, you can safely use it for six months, eight months, however long it takes to get you to your goal while doing all the other things, of course. And then go ahead and go off of it, take a break, give your body a break, bring it back in.

[B]

And would there ever be any. Are there any clinical. I know that the literature, there hasn't been any studies doing anything north of 300 micrograms, but is there any signs and symptoms like with T3? We know if you're overdoing it on T3, as you mentioned, it's like you're gonna start gaining as soon as you stop it, you're start, you're gonna start gaining weight, you're gonna give yourself a thyroid issue, you're gonna start burning off skeletal tissue. Are there any signs and symptoms or clues that maybe you're overdoing it?

[A]

We've heard from a couple people that if they. Cause there have been some people that have overdone it and experimented and wrote.

[B]

In and told us, well, there's abuse here. Yeah. And I just, I want to, I want to pre frame this question by saying the women that are listening, they're like, I'm going to. I know she said 300, but I'm just going to do 600 and not tell anyone. Like there's such a potent. And I say that with love because we are told as women, like, we have to be small no matter what. I mean, you see, we can get into the ozempic conversation maybe another time. But you know, like, there's just this Obsession. This unrelenting obsession. And I totally get it. Like, I totally get you always want to put your best face forward, your best body forward. It's your business card to some extent. Like, I get it. I'm not saying that we shouldn't do that. I'm not pretending that that doesn't exist. But what I think about, just as a clinician in terms of safety is that there is a. Just like the plastic surgery patient that keeps coming back and wants her lips bigger. And she's like, it's not big enough, or my face isn't tight enough or like, whatever it is. Like, I want my boobs bigger. What, I want my butt bigger. Blah, blah, blah. Like, there's a. There's a potential for. There's a. There's a large potential for abuse here because all of us are walking around with some degree of body dysmorphia. And so I just. I wanna. I wanna approach this with love and caution. Like, is there. Cause this sounds great. Like, I'm gonna. Like, I'm gonna buy some of your supplements. Like, I wanna try thyroid fixer. I wanna try these and kind of give you my. My thoughts on it. And I wanna know if there's any clinical reports or anything in the literature or anything where it's like, someone's like, I'm just like, you know what? I need to lose, like, 10 pounds and I need to do it in like six weeks because such and such event is coming up. Let me just like double the dose for a short period of time. Like, I just wanna understand. And maybe paint for the patient or for the listener. For my. Betty is like, what. What are some of the consequences? Because we often, like, with Ozempic, we're like, ozempic's the best. I love it. And like, I'm not saying Ozempic, you shouldn't use it if you need it, but we often marry ourselves to the promise with. And simultaneously divorce ourselves from the side effects. Like, I saw. Just as a very quick aside, I saw this woman, I don't know her name, she's an actress. She has. She's like a young, beautiful, you know, looks just like you actually. Like, she's like blonde, like, beautiful, gorgeous blue eyes. And she's like, I have osteoporosis. And she was like 27 or something. Like, it was like something ridiculous because she's been taking Ozempic for a year. Very, very thin. And now she has bone disease. And it's like, okay, so anywho, that's my little. My little rant, and I will lead in with the question. So can we overdo it? Can we overdo it? Let's. Let's start there.

[A]

Okay. Anecdotally, because we don't have any studies on it, but from some of the customers and even a couple patients that have push the limit a little bit, what we find is you're just wasting money because you're not going to get a stacked effect by using more and you might just get a little bit hyper. So there is. You're not going to see when I say that T2 is not going to affect your thyroid hormone and your thyroid lab values. The other component to that that I'll mention is let's say you were abusing T3, you were using it, and, and you were using it for fat loss like some bodybuilders do. And then you go get a thyroid panel. Your doctor is going to look at your labs, and what's going to Happen is your TSH is going to be in the toilet. Your free T3 is going to be flagged high, and your doctor is going to say you're hyperthyroid now. We need to calm down your thyroid, and you're going to be like, no, no, no, I'm just. I'm taking T3. You didn't know it?

[B]

No, no, I feel great. Yeah, yeah.

[A]

WA will not change your thyroid lab values. Except if an iodine atom comes on and attaches to T2, it can become T3. So, yeah, you might get a little shift in your T3. You're not going to go from, let's say, a 2.0 low to a 5 where you're high, you might go from a 2.0 to a 2.3. So you might get that little bit of a bump where temporarily, if you took too much in a day, you might say, I feel jittery. I feel a little bit jacked up here. And then that's. That's the anecdotal evidence that we've heard from people who have pushed the limit. So nothing dangerous, but you're going to be wasting your money. So just don't do it. Keep nice and steady. Add in the T2 while doing all the things that you should be doing because it does not work in a vacuum. That's the other thing I'll say. And these are big questions that we get from our audience, too, like, well, I'm taking T2, and I took it for a month and I didn't see anything. Are you insulin resistant? Where's your hormones? Are you Sleeping. What's your food intake? What's your sugar intake? You know, are you walking? Are you moving? Are you exercising? How's your stress level? You have to be doing all the things. Nothing is a miracle in this world. Nothing. I mean, even like you mentioned, the GLP is in Ozempic. They come with a boatload of side effects. So nothing is a miracle drug, pill supplement. You have to be doing all the things with it, but it can absolutely help. And I think in this time of our obesity epidemic that we have and the misuse and abuse of the GLPs, where we're seeing a boatload of issues such as, I mean, beyond the lean muscle loss and the facial fat loss and Ozempic phase where people look 10 years older than they are now, we're seeing the osteoporosis and the gastroparesis when it's not used properly. So that's where I think T2 can be such a big mover and game changer in the obesity crisis that we're in because the side effects are little to none.

[B]

Yeah, yeah, yeah. I. I struggle. I struggle with this too, because I have this love, hate. I think ozempic and the GLP1s, I think that they have such a potential, like you said, to help mitigate this obesity crisis. It's like, yes, we. You are better. You are better off not obese than obese. So definitely get these drugs into you now. And, you know, I've had Tina Moore on the show talking about some of the other benefits that she's seeing with, like, regenerative properties in the brain and the heart and the skeletal, like, all these beautiful things when it's at a very low dose, right? So it's like a dose and management issue by the doctor. And you look at Hollywood and you're like, these girls don't need to be on this stuff, but they're on it anyway. And, like, there's just. You know, there's an award I was watching a couple weeks ago, and I'm like, these girls are all so thin. Like, they're so thin. They look so thin and so frail. And it's. Yeah, I mean, like, I. Gosh, like, I struggle with it too, man. Like, I wanna look good, you know? Like, I wanna look good, too. I'm not saying not to pursue that, but sometimes, like, you know, there's one actress in particular, Nicole Kidman. I think I was like, oh, my God, girl, you look so thin. Like, you just look like you're gonna snap in half. Like, I just Want you to be squatting and lunging like you can. There's. Anyway, okay, my opinion. I'm gonna get. I'm gonna get some letter from someone else so we can move on. Okay. So let me just. I got some questions from the Bettyverse. I posed this question on Instagram. I was like, I got the thyroid doc coming on, so let's talk about. Let's talk about thyroid. Give me some of your questions. And there are some really good ones. Like, there were some really, really cool ones. So let me just pull these up super quick. The one, I can tell you this came up quite a bit is they wanted, like, there was a couple of questions that wanted to know how you can discern between some of the symptoms of perimenopause. And we'll call it thyroid pause. Credit Dr. Sarah Zahl, or formerly known as Gottfried. She sort of. I remember hearing that term from her. Thy thyroid pause or thyroid pause. So how do we know that it's the thyroid as the culprit if it's the sex hormones that are the culprit? Can two truths be valid at the same time? Can it be both? Like, how do we discern between the two from maybe a clinical standpoint? I mean, labs obviously, is like, you'd be able to see from labs, but how do. How do women know? How can we distinguish between the two?

[A]

Ah, such a good question. And I love Sarah for saying that. I have absolutely grabbed onto that term and have been using it. And so my definition of thyroid pause is when your thyroid gland craps the bed after the age of 40 due to fluctuating hormones.

[B]

What a definition.

[A]

Right? It's easy to remember.

[B]

Yeah.

[A]

But I truly believe that every single woman needs to have their thyroid checked fully. Like we talked about on the show. Needs to have their thyroid checked after the age of 40. Because here's what we know. We know that when hormones start to fluctuate, and I'm going to. I'm going to back up and go to pregnancy, and then we'll tie this to perimenopause and menopause.

[B]

Oh, yeah. Yeah.

[A]

Pregnancy is a beautiful time. And it is a horrendous time for your hormones because they are on a roller coaster of all roller coasters. And at that point of time is when Hashimoto's often presents itself because those fluctuating hormones in our body, that's a stressor, and pregnancy is a stressor, and that's all we need is a stressor. It doesn't have to be a divorce, a death A move. It can be within you. It can be a viral infection, it can be a toxin load. It can be a beautiful thing like pregnancy. But that creates a hormonal cascade in your body that flips on that Hashimoto switch. So we often see Hashimoto's turn on in puberty, pregnancy, perimenopause, menopause, and it's the fluctuating hormones again. So as soon as your hormones start to fluctuate. Yes, we know that they can. It can happen earlier. Progesterone can start to tank in a woman's 30s. But really, once you hit 40, that's where, you know, really, shit starts to hit the fan. So this is where we need to. To test thoroughly. And that's where we're at.

[B]

That full thyroid panel that you were talking about. Like, we're not just looking at the TSH and T4. We're looking at everything. We're looking at free T3. We're looking at. Can we actually. Actually, I didn't ask you. Can we look at T2, did you say? Did you mention this at all? Can we.

[A]

There's not a test for it. There's not. I mean, there's a test for it for the studies. So they did measure T2 levels in the human studies that we talked about, but that test, while in existence, is not available for the general public clinicians. Not yet, at least. Not yet.

[B]

Okay.

[A]

Yeah.

[B]

I have another question here. Does hypothyroidism change the texture of the hair? Does it make it dry?

[A]

Oh, goodness. Yes, yes, yes. So with hypothyroidism, and this is where. So when we are talking about this kind of blending that first question with this question, there's so many overlap in the symptoms. And that's why I'm a huge fan of treating both, like test both, treat both. So with our patients, we don't just test thyroid. We're gonna test all your hormones too. Because if a woman is coming in saying, my hair is falling out, it's dry, it's brittle, it's breaking, and, oh, by the way, I also have brain fog and weight gain, and I'm so tired, that could be hormones, that could be thyroid, that could be both, because they play together. So with hair, absolutely. It could be low thyroid function, it could be nutrient deficiencies, it could be low estrogen, it could be low testosterone, it could be high testosterone. So there are so many overlaps with hormones and thyroid that you really have to look at it all. But, yes, specifically for the hair. That's a Big one. That is a big one with thyroid. And I try to tell people, listen, it could be this, it could be low protein intake, it could be low ferritin levels. But let's absolutely look at the thyroid and start there and then start going down that checklist of all the other things that could be affecting your hair.

[B]

Great. This was a. This was an interesting one. Do breast implants impair thyroid function? And I was saying this to you in the pre chat. I'm like, this is a cool question. I never would have put these two together. Do we think that there is a connection between the two in some people?

[A]

So I've looked into this as well. I've talked to experts, I've talked to breast implant illness experts about this. And it really comes down to that unique individual. Just like we're all sensitive to some things. People, some people are more sensitive to medication, some people are more sensitive to, let's say, mold exposure. Where you and I could walk into a moldy room and yeah, we're gonna get stuffy and feel like garbage for that day, and the other person's gonna walk in and be sick for a year. So it all depends on how your body is responding to that. Let's say we'll just call it like an external force. So when demand.

[B]

Some type of demand.

[A]

Yeah, some type of. So I don't know what you would call it. Something coming into your body that it's like, wait, what is this? How do we respond to this? So it really comes down to that autoimmune component. When we're looking at hypothyroidism, 95% of all hypothyroidism is Hashimoto's. It is autoimmune. And with that 95% being autoimmune, how is the immune system going to respond to something like an implant coming into the body? For some people like myself, I've had them for 20 some, almost 30 years now.

[B]

No problem.

[A]

No, no autoimmune flare. I have no issues whatsoever. But in another person, in a couple of my friends, they had a breast explant surgery and they're like, oh, I've never felt better. The poofiness in my face is gone. My dark circles are better. I'm not sick anymore. So their body was reacting to that implant. And then to go one step further, like we talked about, a leak. So now what if you have a rupture? What if you have a leak now that that saline solution or the silicone that's inside the implant is now getting into your system. How does your immune system. How does your body respond to that? And it might kick up a flare and it might make you sick and cause systemic inflammation. It's all unique to the individual.

[B]

So we've been talking a lot about some of the, we'll say shortcomings in the traditional way that thyroid is often handled in the sort of classic allopathic system. We've been talking about our opinions on how we might do them differently. What I would love for you to do as we're sort of wrapping a bow on this is like, we've been talking about T2 potentially as a. As a supplement. Supplement form. Right. We're talking about supplement form. We're not talking about injectables. What are some other action items? So someone who is suspecting that they have hypothyroid. So some of the. Some of the. Like, they're feeling cold all the time and their hair's falling out and they're gaining weight and they're not able to sleep, and maybe their periods are super, super heavy or, you know, all these sort of classic symptoms that we've outlined, what are in addition to the testing. So obviously we want to have the data to be able to make clinical decisions for them. What are some of the levers that someone listening might be able to pull in her own life? And I always like to draw on nutrition and fitness and stress management as sort of the three primary ones. But I'm sure there's. Even just within those three large verticals, there's lots of subcategories. What are some ways that you like to counsel your patients? Like, are there foundational things that everybody needs to be doing? I know you come from a bodybuilding background. Physique compet, like a physique competitor. Is resistance training part of your healing protocol? Like, what are some of the things that you're gen. Like you find yourself saying over and over and over again to your patients in terms of what they need to do in their own lives.

[A]

Absolutely. Okay, so first we start with. We kind of touch on some supplements, but there's a list of supplements that I call the no duh supplements, meaning, of course, duh, you're gonna take em every day. I simplify it that way. So that's your vitamin D, your magnesium, that little bit of iodine that we're talking about. Essential, essential amino acids, minerals, like B minerals. Those are all the basics. And when you take those in without getting all fancy. I know there's a lot of fancy supplements out there. When you Take the basic liver support. You take those supplements every day just to give your body that baseline structure, the basic building blocks to be able to make thyroid hormone, to convert thyroid hormone. That in of itself just giving your body the basics, that's providing the foundation support. Then we go into, okay, what are you putting in your mouth? And you know, with your community, it's a little bit of a higher level of knowledge that I don't think we have to say. Of course, avoid sugar, avoid seed oils, cut out the processed foods, but absolutely bring in the no brainers with all of that because we all tend, even the best of the best tend to kind of float a little bit with our eating and we start letting little things come in and we stop reading the labels because we think that we know. So if you really are struggling, go back to the basics of what you know to be true. You know, you're not supposed to be consuming sugar. That's hugely inflammatory. And anytime we inflame the body, we're inflaming our thyroid, we're kicking up our autoimmunity. And many of us have a propensity for autoimmunity. I mean when we look at the, the data on hypothyroidism and Hashimoto's, it's. I mean it's 12 million people that we know of that are diagnosed with hypothyroidism. Hashimoto's and then there's another 8 million that are undiagnosed. So supporting the immune system and calming down inflammation, avoiding the seed oils, avoiding the processed foods, that's the no brainer part. Now we'll go one step further with the nutrition and get into gluten because that's worth mentioning. Oh yeah, is it has something called molecular mimicry to the thyroid gland. So I always love using analogies so people can understand. So we talked earlier about those antibodies and I equate those antibodies, those autoimmune antibodies as soldiers and they like to go out, beat up your thyroid and start a war with your thyroid just because they are confused soldiers and they think that your thyroid gland is a bad guy and it's the enemy. So those soldiers like to go out and beat up your thyroid. So now when we consume gluten, it looks so much like the thyroid gland that the soldiers see it and they go, hey, there's another invader coming in. We need to go kick some ass. We need to start a war. So they go out and they literally beat up your thyroid gland some more. So if you want to start Your own autoimmune attack on your thyroid. Just keep eating gluten because you're going to build that army up. Those soldiers are going to multiply, and every time you consume gluten, you're going to have an autoimmune attack. Now, some people would be like, well, I don't get bloated. I don't feel bad. You might not feel it immediately. You might feel it two, three days later. Or it's just creating such inflammation in your body because it's part of your daily diet that that's why you. You're saying, well, wait, why am I gaining weight? Why am I sick? Why isn't my thyroid functioning? Well, it could be the gluten. So I think that that's a universal law for pretty much everybody. Not just hypothyroid patients, but everybody. And then to answer your question about exercise, love resistance training. I mean, listen, I understand everybody's at a different fitness level, and maybe you're dealing with some injuries or whatever, but the worst thing you can do, and quite frankly, the worst thing we can do as women, is be cardio bunnies. Cardio is just number one. It's going to increase your cortisol. So cortisol is a stress hormone. When cortisol goes up, which I didn't even mention. I totally forgot to mention it in the reverse T3 conversation. High cortisol impairs T4 to T3 conversion. High cortisol will increase your blood glucose, making it. Making you more insulin resistant. We don't want to be in that high cortisol state. We also don't want to burn off our precious muscle because that would. That's what makes us more metabolically active. And, and I know you've already talked about this on the show, about the importance of keeping our beautiful muscle, lean muscle mass on. So we don't want to be cardio buddies. If you are in the. If you can't go out and lift heavy and you can't do the resistance training, you can always find an alternative. Whether it's bands or lighter weight or if you have a lower body injury, you do upper body until that heals. But you have to provide some kind of resistance to the muscle and not just be doing the elliptical or doing your peloton. You're just. You're making your situation worse. I get the mindset. I know, I was there. When you are in that frustrating place where you're like, I'm doing all the things, the weight's not coming off. It just keeps Going on. What do we do as women? We do more cardio, and then we do it twice a day, and the.

[B]

Doctors tell us to do that, too. Eat less, move more. What do we think when we say move more? We think, I should get on the treadmill and run.

[A]

Exactly. Exactly. It is so detrimental to a woman's body and to a woman's thyroid function that, hands down, we have to stop being cardio queens.

[B]

Yeah. I'm gonna take it a little step further because you're so kind, and you're like, even if you don't like it, it's like, I don't care if you don't like it, you have to do it. It's like, you know what I also don't like? I also don't like taking out the trash. But if I don't take out the trash, then the garbage people are not gonna pick it up, and then there's gonna be, like, a backload of trash in my home. But I do it right. It's like, I also don't like doing the laundry, but I also like to have clean clothes. Right? So it's like, there's lots of things that I don't like to do that I do. It's called being an adult. So. And I say. I say it with love. Betty's I love you. This is why I'm saying it. And I'm willing to cut my head off for you to come at me, because it's like, you just. I know you don't. If you don't like it. I mean, some of you, when you get into it, you're like, oh, my God, I feel so strong. I feel so good. I feel so great. My energy and all the things that you can get from exercise. But for those of you like, listen, I've gone to the gym, and I don't like it. It's like. And you still have to do it, like, sorry, but it just has to be part of your life.

[A]

It really does. It just really does. Good. You could be blunt with your audience then.

[B]

Yeah, yeah.

[A]

And I'll just back you on that stuff.

[B]

She's like, what? She said. Yeah, right.

[A]

Lift heavy stuff.

[B]

You have to lift heavy stuff. And, you know, it's like, if it can't be heavy, like you said, if it's an injury, light in a range of motion that you can own, but just move to muscle failure. If it needs to be 25 reps and not eight, no problem. Just do. If that's, like, where you get close to muscle failure, like, I Am still cheering you from the sidelines because that is an appropriate approach to resistance training. And I think the sort of wrapping this up, when we're talking about thyroid health, we're talking about all these different levers that we can pull. Avoiding the gluten and incorporating some of the supplements that you were talking about, the resistance training, this is all improving literally, like, capacity at the physiological level. Right? So, like, you are improving the thyroid's capacity to do her job. You're providing the minerals and providing the substrate for this, you know, these conversion issues. We're healing the gut, so we're helping the conversion there. We're improving the insulin resistance through resistance training, which is helping the conversion there. And, you know, all the places that we see T3 and T2 receptors and the skeletal muscle like we've been talking about. So I just think that it. It's when we're thinking about health, like any type of health programmatics, it's like, how can I improve my capacity? And like I said, sometimes it's just we gotta put on our big girl pants. We don't like the. We don't like the resistance training. You gotta do it anyway. It's like I'm asking for 45 minutes a couple times a week. You can do that. You know, that's it. Yeah.

[A]

Yeah.

[B]

All right, so tell us about, you know, in wrapping this up, I know we don't have a ton more time together, but I was checking out your website. You got a really thorough supplement line. So tell us a little bit about where people can find more about you. I know you have a podcast I'm going to be coming on soon. Tell us about your podcast. Tell us about you. Tell us about the supplements. Where can we find more?

[A]

Absolutely. Okay, so podcast, the thyroid Fixer podcast, and a lot of great guests. I mean, Dr. Stephanie is going to be on it. We dive deep. I do a ton of solos on there, too. Just diving into more about thyroid and hormones and all the things that we talked about today, you can go to doctoramy.com D R A M I E. That's where if you're interested in getting help with your thyroid and actually working with experts, myself and my team see patients we prescribe to all 50 states, parts of Canada as well, because I know it's really tough to get proper thyroid treatment and even a reverse T3 up there.

[B]

Good God. Yeah. I mean, I. My audience is American, but obviously I live in Canada right now, and I can't tell you the amount of Canadian people that reach out. And they're like, I am sending the doctors your podcasts. I have shown them the lab guide that you. And like, they don't listen. It's like there's this weird. There's something still in Canada that we have to fix. Maybe with two Xs like your podcast. We have to fix them. We have to just fix the attitude of some of the medical doctors in Canada. And this sort of like, nope, I don't need to look at that. You know, kind of. So I know what provinces in. In. In Canada, the major ones.

[A]

I don't have a Honest, but all the big ones. Okay, the big ones for most of Canada. And then you can go to. And we're going to get you a link, which I didn't do beforehand, but just we're going to go to betterlifedoctor.com forward/betty, because I love your Betty's. And if you use the code Betty20, you can get any of the fixer supplements for 20% off. We'll give that to your audience as well. I just thought of that on the fly, but we're going to do that. And so what we were talking about was thyroid fixer and metabolism fixer contain T2. And they were my. They're my babies. They're my flagship product. And then everything else was built out for what I see in my practice, from the insulin resistance to low testosterone in women, and they can't get testosterone from their doctor whatsoever. So we have hormone fixer. We have all of the nutrient supports. We have things that people run into, elevated SHBG and DHT levels. So we really have something for everyone that really ties into all of these thyroid and hormone symptoms that start to occur as we move into perimenopause and menopause.

[B]

Cool. Awesome. That's very generous of you. Thank you very much for that. We'll make sure that those links are in the show notes as well. Dr. Amy, it's been a delight and I'm very excited about coming on your show. We're going to have a lot of fun there tonight, too. We're going to talk probably about. Probably about exercise physiology and perimenopause and nutrition. So we're going to have a really great time. Really excited.

[A]

Love it. Love it. Thank you, Steph.

[B]

All right, all right. I hope you enjoyed today's episode and I must give you the obligatory legal and medical disclaimer here. This podcast, Better with Dr. Stephanie, is for general information only, and the advice recommendations we discuss do not replace medicine, chiropractic or any other primary healthcare provider's advice, treatment or care. In the consumption of this podcast, there is no doctor patient relationship that has been formed and the use and implementation of the information discussed are at the sole discretion of the listener. The information and opinions shared on this podcast are not intended to be a substitute for primary care diagnosis or treatment. In other words, guys, be smart about this. Take it with a grain of salt. Take this information to your primary healthcare provider and have a discussion with him or her to make the best choice. That is for you. Remember, I am a doctor, but I am not your doctor and these conversations are meant for educational purposes only.