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I want to empower and educate you. Labs do that when you have your numbers in front of you. You are already empowered right there. You need the education piece to go along with it, and then you are an unstoppable, unapologetic badass. Right there. Welcome to the new and completely reimagined Thyroid fixer podcast, a podcast that refuses to sound like every other health show out there. We're here to disrupt this entire space, and now you are part of that disruption. If you're listening right now, it's because something inside you finally said, I'm done being ignored. And I'm here to tell you good, because this is where everything changes for you. This is where you say, no more. No more being dismissed by your doctor. No more being told your labs are normal. No more recycled medical advice. No more recycled biohacking advice. No more being told to accept what you know isn't right here. You'll get truth. You'll get clarity. You'll get information you can actually use tools, strategy, and guidance you can apply right now to take back your energy, your hormones, your metabolism, and your life. Every episode will give you something real, something that moves you forward, something that reminds you that you were never the problem, the system was. This is the Thyroid Fixer podcast. This is your turning point. This is where you rise. Get ready. We're about to disrupt everything you thought you knew about thyroid and hormone health. Let's go. You have questions about your thyroid, about your labs, what they mean. What about your hormones? What about insulin? Why are you gaining weight? Why are you so tired? Why are you losing your hair? Why won't my doctor listen to me? Why won't my doctor test these things? All of these questions that you have running around in your brain, and you know that if you just had the answers that that could push you over the edge into optimal health, that you could be that badass human that you are meant to be. Well, I got you covered there because I am going live every single week in the just fix your thyroid Facebook group. That is my Facebook group. A beautiful community just filled with amazing people where I am in there, my nurse practitioners are in there. My health coaches are in there. There are patients in there that have been with me for so long, they're experts in their own right, and they answer just the way that I would. So we have you completely covered in this group. So not only can you post your question every single day, every single hour, if you want, you can mark your calendars for our weekly live Q and A sessions. We where you get to ask your question to me and I'm going to answer it live on air. And not only that, we are doing product giveaways, we're doing working with our team giveaways. You're going to want to be in there and actually be live on that call. If you're at work going in the closet, just shut the door. Take minutes for yourself, take a half an hour for yourself, take an hour for yourself so that you can get the information that you need to, to bring yourself into optimization land where you're not looking sideways at a brownie and gaining weight at the same time, where you can feel amazing every single day. Because that's my goal for you. You know that I love, love, love to answer your questions and this is the place where you can get them answered live. It's one thing to actually get your labs done, a full lab panel including everything that you need for your thyroid and your hormones and it's another thing to do them properly so you get accurate results. Now here's the good news. If you're listening to this and you're saying, well, I don't even know my numbers for my thyroid and my hormones because my doctor won't test them. And I keep asking and I keep getting told no, because your labs are normal, it doesn't warrant more testing. You're not old enough to have your hormones tested or they're just going to be in the toilet anyways because you're aging and all of your symptoms that you're having, yeah, you're just getting older, so why don't you just eat less and exercise more. The bottom line is in order to know exactly what's going on in your body and to do something about it, you need to test and not guess. But you have to test the right way. So one of the big questions that I keep getting asked over and over again in the just fix your thyroid Facebook group, which of course I invite you all to join because it's the best community on Facebook, quite frankly. And in there you can ask any question you want, you can post your labs and I'm in there every single answering your questions on our Facebook live. So if you want to ask me a direct question, jump over in there and be on the lives. But the big question I keep getting asked is about the timing of thyroid labs and hormone labs. So. Well, here's the good news that I started saying in the beginning. We now offer an at home comprehensive thyroid and hormone panel. The test kit is shipped directly to your door we test TSH free, T4, free, T3, reverse T3, and the TPO and TGA antibodies, as well as progesterone, estradiol free and total testosterone, sex hormone binding globulin, FSH and lh. So this gives you that beautiful picture of exactly what is going on in your body with your thyroid, the master gland, head to toe, it runs the show. And with all of your sex hormones, they give you life. That help you sleep, that improve your mood, improve your libido, your hair, your body composition, protect your muscle, protect your bones, protect your heart, protect your brain. Unless you know exactly where you're at with your thyroid and hormone health, you know nothing. And chances are you are going to get a band aid medication from your doctor, like an antidepressant, a sleeping pill, a statin, a blood pressure medication. Because guess what? When your thyroid is in the toilet, it's much more than just how you look, feel and perform. It is about your overall health and longevity. Yes, without thyroid hormone, you will die. And with low thyroid hormone, you're just going to die sooner. You're at a greater risk of cardiovascular disease, Alzheimer's and dementia, as well as osteoporosis, which we know if you fall and break your hip or break a bone, you are at a 50% increased risk of mortality, meaning dying, because you will be immobile. The best way to prevent this is have adequate hormone levels, have your thyroid functioning optimally, and let's get the test results done the right way. So here's how you get the most accurate results. Number one, we're going to go over the tests. If you are not on medication of any kind, no one has ever diagnosed you with a thyroid condition. And you've been told that you just don't need hormones because you know that's just part of getting older. So it's totally normal for a 50 year old woman to have a zero hormone function per conventional medicine. We want you to have hormone function though, but let's just say you're in that boat and you haven't had an ounce of hormone replacement or you don't have it right now. Maybe you were on it before, now you're not. No medication. Okay? Thyroid, you can really test at any time, but you definitely want to test in the morning now with all labs. You want to go in a fasted state, just go in a fasted state. It's like wake up, go to the lab, do not pass go, do not collect $200, just do not anything except water, don't drink coffee, don't take a supplement, don't, don't even take, I don't know, your antidepressant band aid medication that you normally take in the morning. Take nothing. Just go clean, wake up and go to the lab, preferably before 9am and this goes for thyroid and hormone function. Go to the lab before 9am in a fasted state. That's all you have to do for thyroid and you can go. If you're just testing your thyroid, you can go at any point of time. Now these rules do apply for this at home comprehensive fixer test with thyroid and hormones that you can order. We'll put the link in the show notes. All of these rules apply whether you're going to a lab or whether you are doing an at home test kit. All of these rules apply. So for our lab panel, because you are testing hormones, preferably if you are a cycling woman, I want you to test days 19 through 22 of your cycle. So whether you have a lab order in your hands from your doctor for estradiol and progesterone or whether you are doing the fixer at home test, you want to test days 19 through 22 of your cycle if you are a cycling woman, if you are still having regular periods. So again, no thyroid medication. You're testing thyroid test in a fast. And Steve, before 9:00am any time of the month. If we're adding on hormones, you're not on hormone replacement therapy. You can test any time of the month if you are in perimenopause with erratic cycles or in menopause with no cycles. If you are still cycling and having a regular period every 28 to 30 days, you want to test days 19 through 22 of your cycle. Still fasted in the morning. Don't wake up and take your birth control pill. Don't wake up and take anything. The rules still apply. Go to the lab before 9am now let's get into what if you're taking something. So let's say that you are on thyroid medication. This is going to include T4 only, which we know doesn't work. This is going to include natural desiccated thyroid armor np. This is going to include a combination of Synthroid or, and, or Nile thyronine or cytomel, T3 or any kind of compounded thyroid medication that you get from a compounding pharmacy. And this also includes a thyroid glandular supplement. So if you are on thyroid glandular by the fixer or any other thyroid glandular supplement, it will say thyroid glandular on the bottle. Then you want to avoid that because all of those medications taken in the morning before your lab can view the results. The other rule with supplementation and thyroid is to avoid any biotin containing supplements. So these are usually in your B or your hair formulas. You want to avoid those for five to seven days before your labs because what that will do is it will skew your TSH and your free T3 number and we want accurate results. Now back to the medication number one, we are avoiding anything the morning of. Nothing goes into your mouth the morning of your labs. Believe me, I have been there where I accidentally took my thyroid medication in the morning. I was literally driving away from the lab. I had already given blood and it hit me. I went, oh crap. I took my thyroid medication that morning. So that is going to skew my free T3 result. We have other podcasts on this and I, I feel like I cannot say it enough because there are messages out there by other people to take your thyroid medication in the morning and then test four hours later, which is called testing at the peak. Now this is really for T3 containing medications like your NDT, armor, NT, lyonine, C. Those T3 containing medications are going to artificially bump up your free T3. And I've said this over and over again. Ken Barry and I talked about it on the podcast that he did with me. You can find that. I forget what episode it was a couple weeks ago. I don't know what episode Ken Barry was, but do a Google search or do a search in your Apple or Spotify, you'll be able to find an amazing episode. I love Ken. He's so straightforward, so down to earth. But even he said, no, you do not take your thyroid medication before your labs. You do not test at the peak. Because what will happen is you will get this falsely elevated free T3. And there's no optimal range for testing at the peak. There is zero optimal range for testing at the peak. The Institute for Functional Medicine hasn't designed one. Functional Medicine University hasn't designed one. All of my Functional Medicine colleagues don't have one. There is no optimal range for testing at the peak. So don't do it. Here's where it gets even more nuanced. If you are taking something with T3 in it. So this is your NT Thyroid, Armor, Thyroid, any kind of natural desiccated thyroid, a compounded T4 and T3, lyothyrene or cytomel separated out or a thyroid glandular supplement. You must hold this 18 to 24 hours before your labs. Now that doesn't mean to just take it out and wait three days. It doesn't mean more than 24 hours. I did not say 36 hours. I didn't say 42 hours. I said 18 to 24 hours. After you take your T3 containing whatever medication or supplement, why you want to time it in this gap is because anything less than 18, you're going to get a falsely elevated free T3 to where your practitioner, your doctor can look at it and go, well, this looks really darn good. And you're sitting there saying, wait, no, no, no, I still have all the symptoms. The scale keeps going up every single day. My hair is still falling out, I'm still tired, I'm still constipated. Well, don't test under 18 hours. You did this to yourself. You want an accurate result? Go get retested and hold your medication in that 18 to 24 hour gap if it contains T3 and again, that includes thyroid glandular supplements. If you go over 26 hours now, you're going to be artificially low to where you could obtain more medication and be overmedicated. Now, that being said, most doctors are not keen on increasing T3. Most doctors only give baby doses of T3. Even integrative and functional medicine practitioners that you have heard heard me complain about over and over again on this podcast, they will give you more and more and more NDT medication which can then drive up your reverse T3. So that's not a better scenario either. No, we don't want to be over medicated with T3, but we also don't want to be over medicated with T4. And if you withhold your medication for longer than 24 hours, you will get a false low. Don't do that. 18 to 24 hours with anything containing T3. T4 technically doesn't matter because it's very, very slow acting. But just to be on the safe side, don't take your T4 in the morning of your labs. Just hold it. You can take anything right after you leave the lab. Pop your T3, pop your armor, pop your T4, pop your thyroid glandular supplement after you give blood and leave that lab, or after you use our at home in the morning and you're done, then you can take your thyroid medication. Now, when it comes to accurately testing hormones, here's where it gets a little bit more nuanced. So again, if you're not on hormone replacement therapy, you don't have to worry about holding anything. If you are on birth control, there's nothing you can do you just have to take your birth control? We know that birth control is synthetic hormones. It will artificially lower your own progesterone production and possibly affect your estrad levels as well as. But when you're working with a practitioner or if you're doing our test plus consult and you're getting an expert analysis done of your labs, make sure you tell your provider on my team that you are taking birth control. That way we can look at it from that lens and say, oh, well, then it makes sense that you're 35 years old and you have the progesterone level of an 80 year old because you're taking birth control. Just tell us there's nothing you can do. You're on it. We can discuss that down the road. I have other podcasts on just birth control and why Sometimes we just have to use it if we're avoiding pregnancy. But if you're at a certain point in your life, maybe let's think about taking it out because it is affecting your hormones. Okay, nothing you can do about birth control, but maybe just don't take it that morning. Right again, because you're still ingesting synthetic progestins, synthetic estrogens, possibly even on a low estrogen pill, you're still ingesting synthetic hormones that will skew results. So don't do it. Take it afterwards. Do you want to know the biggest health secret that nobody is talking about? Everything. I mean, everything certs in your gut, but every day your gut is fighting the silent war against all the processed foods and the stress and the pesticides and the toxins in the air that you breathe. And then when your gut's in trouble, your whole body feels it, not just your gut. So here's where it gets a little bit crazy. Most people are spending money on probiotics that don't even work. I see this every day in the practice. Why? Because 99% of those traditional brands die in your stomach acid before they even reach your gut. So you might as well just flush them down the drain. That's what makes Just Thrive Spore based probiotic completely different. I have tried it and I am sold. I am totally sold. And when I learned more about it after I interviewed the founder of Just Thrive, my eyes were opened up. I said, this is why I see no change in patients when they throw in a typical probiotic that they got at the grocery store or at the nutrition shop. You need these live probiotic strains in order to do anything in your gut. Just five is the only one clinically proven to arrive at 100 alive in your gut. That is crazy. 100. And it does something no other probiotic can. It turns your gut into an antioxidant factory, creating protective compounds exactly where you need the most. So that means better digestion, better immunity, more energy, a lot easier weight management. Just Thrive Probiotic comes in capsule or berry flavored gummy. So there's an option for everyone in the family. 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If you're in your 20s and 30s, you may be on progesterone because it's beautiful for PMS and PMDD and heavy cycles, irregular cycles, estrogen dominance, progesterone is king. It's beautiful. Also for depression, the new antidepressant is progesterone. So if you're on progesterone oral, you can take it the night before. And that's usually when you're going to be dosing an oral progesterone anyways because of the sleep benefits. If you're using a progesterone cream, you can use it the day before. Whether you're using in the morning or at night. You can use progesterone cream the day before. A trochee, which is almost like a little wax ball that you put in the side of your cheek. It's absorbed sublingually or mucosally into your mouth, into the bloodstream through your mouth. That you can do the day before as well. Just nothing the day of or the morning of if you are taking now next we're going to move on to testosterone because that's the second hormone that declines or get done hormone. If you are taking testosterone subcutaneously via injection or intramuscularly via injection, this is going to be a testosterone cpionate, testosterone propionate, testosterone enantate. We usually use cypionate for ladies, Propionate, nanothate and cypionate for guys. It just depends. It's, it differs in the esters and how long it actually works in your body. Testosterone sipionate for women, usually a once a week dose. Testosterone cypionate most common for men, usually a once a week dose. This can be split up into multiple doses as well. Testosterone propionate is dosed more frequently because it's very fast acting and n and theta is usually once a week as well. So let's start with the ladies, then we'll go with the guys. Ladies, if you're doing a testosterone injection, a testosterone sipionate, try to time your lab to be six or seven days after you took your last injection. Why is that? Let's say you take an injection and you test three to four days later, you're going to get an abnormally high reading. Now if you're working with us, we can obviously look at it through that lens and say, okay, well that is about right for three days post injection. But if you're not working with a skilled practitioner who understands that, they're going to think that you're on too much testosterone and if they're prescribing it, they're going to drop your dose. So you definitely want six to seven days. Just basically time your testing the day that you would normally do your injection and do it after you test. Same goes for guys, six to seven days after your last injection. Even more important for you guys because you're going to be on a higher dose of testosterone. That's definitely going to give us an abnormal high. Now let's say you are multi dosing through the week, guys, or if you're on propionate, if you're on propionate, you're just going to have to time it so that maybe you do your last shot of propionate. If you're doing it every other day, do it two days prior to your labs and go that morning and then you can do your shot. Sivianate and nnthe 6 to 7 days after you do your shot. If you are doing a cream, ladies, guys, you should never be on a cream or a gel. It's never going to work. If you are, I'm sorry, get away from your practitioner. Ladies, if you have decided to do a cream. Testosterone, that again, you can do all the way up to the day before. Do not apply creams the morning of your labs because they will enter your bloodstream and they will affect the results. Nothing. The morning of your labs, everything goes up to the day before. Except injections. Except injections. That's where you have to time it a little bit differently. Testosterone trochee, same thing the day before, the day before. Now we'll go to estradiol or a bi est cream. Again, if we're doing a cream for our estrogen replacement. Up to the day before, nothing the morning of the labs. Unless, of course, there are some practitioners and you will get these direct instructions from your practitioner that you're working with. There are some practitioners that like to test estradiol, FSH and LH on day three. Some people like to test on day 12. The in general rule is day 19 to 22 if you're still cycling. But again, if you're not cycling, you can test at any point of time. Ladies, now I just want to focus on the hormone replacement piece, if you are taking it and how to time it. Now, some women will take an estrogen injectable, so an estradiol and then they injectable or an estradiol valerate injectable, not common. We only use them in practice with our ladies that just really struggle with getting their E2 levels up with a patch or cream. I'll get to the patch here in a moment. But injectables do exist. Some women use them. So again, that rule is going to be you want to do pretty depending on how you're dosing it. Some people dose it once a week, some people dose it every other day, some people dose it every day, which I find incredibly difficult to do without going into estrogen dominance. But that's just a little side note there. You want to give a gap, preferably a two to seven day gap, depending on how you are dosing your estradiol injection and what ester of estrogen it actually is, or estradiol it actually is. Okay, patch, patch. Ladies, you're changing out that patch twice a week, right? So the last thing you want to do is time your labs to where you're swapping out the patch that morning and then going to the lab. When we apply a patch, we naturally get a little bit of a burst, a little bit of a bolus dose. Technically, the patch is designed to deliver the same amount of estradiol daily, but it's just biology and it's the natural course of things that when you apply the patch you're going to get a little bit of a boost, a little bump in your estradiol. So for that I tried to tell our female patients to please go to your labs. Like time your patch. Maybe you have to change it up the week before in order to time it properly for your labs. Labs sometimes take some planning, it takes some forethought. So look ahead to when you are going for your lab or when you're going to do your at home test and plan this stuff out so that you're not a day before going, oh crap, I took biotin. Oh crap, I just took my testosterone shot. Oh crap, I just put on my estrad patch. So because we are changing the estradiol patch every three and a half days, you want to try to go on day two or three of that dosing schedule. Don't go on day one when you first put on your patch creams the day before we already talked about injectable and now there is the patch. I don't recommend ever being on oral estrogen if you are, I highly suggest you think twice about it because your risk of blood clots is significantly higher and your SHBG is going to be high as well. But again, if you are taking an oral estradiol or a trochee the day before, the day before, the day before, nothing. The morning of now when we're looking at shbg, there really is no timing or there's something that you have to withhold. If you're taking SHBG fixer in an attempt to lower your SHBG levels, you can take any thing up to the day before your labs. What you want to avoid is anything containing biotin, but there are no other supplements that you necessarily have to avoid to get proper results for your thyroid and your hormone labs. So if you're just testing thyroid and hormone labs, you don't have to worry about eliminating any other supplement out there. Nothing else will skew your labs like biotin will. So that's the only one that has that rule of a five to seven day hold cold. All other supplements can be taken up to the day before your labs. Nothing the morning of. If you have to take things for sleep the night before, that is fine. Nothing the morning of, nothing. The morning of LH and fsh. Again, not affected by anything that you're taking. Again, your, your estradiol is reflected, your estrad dose, your estrad level. If you're taking BHRT, you is going to be reflected in the LH and FSH. So when that FSH goes above a 25, that's where inflammation is present. That's where we see a widening of the midsection. And that if you are on vhrt, that tells us that you're not on enough estradiol. I have seen so many women come into the practice, they're on a.05 milligram patch or they're taking estradiol in some way, shape or form and their FSH is a 60. Well, okay, you're not on enough estradiol, then that FSH should be below a 25. So the FSH and LH are not affected by what we do or take, but they are definitely reflective of your current perimenopause and menopause status, as well as how much estrogen you're actually on. And if you are taking enough now with shbg, let's go back to that for a moment. The big question that keeps popping up and we do have a totally separate episode on shbg. Just side note, if you ever want to search a topic, what you do is go into Spotify or go into Apple Podcasts. Those are the only two that I use. I don't know about any other platform. Go in and at the very top that search bar you can put Thyroid Fixer and then whatever it is you want to search for, Thyroid Fixer, T2, Thyroid Fixer, SHBG, Thyroid Fixer, Progesterone, Thyroid Fixer, Reverse T3, and all of the episodes containing that or about that topic will pop up. It's really nice and easy to do shbg. We've talked about it on a different show on a different episode. But what drives SHBG to elevate? Being on Estrad, being on testosterone, being on T3, being hypothyroid and not being properly medicated or properly treated, Low hormone function, not eating enough protein that will drive up shbg. And eating a carbohydrate restricted diet, which many times we have to do because of insulin resistance or it just works better for our body. Some of you are carnivore, some of you are keto. But that good healthy lifestyle can oftentimes drive up SHBG. Just like taking the beautiful hormones like T3 and testosterone and estradiol can drive up SHBG. It's ironic, but it just happens. But there's nothing you can do. SHBG is not going to necessarily fluctuate from day to day or be affected by you taking those beautiful hormones. So there's nothing you have to do or be concerned about with SHBG as long as you are following all the rules that we just laid out here. You will get accurate testing again whether you're doing it at home with our brand new at home comprehensive thyroid and hormone panel that is discussed with you by one of our experts. Click the link below to grab yours. We have an amazing price. So much lower than your CO pay, so much lower than Ulta labs, so much lower than any lab test now or direct labs. You cannot even get the panel done. For what we are charging on Alta labs, that thyroid and hormone panel combined well over $300. I actually think it's more like three. I think it's like 450 when you combine those two together. 400. 450. We are giving you an at home test with all the thyroid, all the hormones plus an expert analysis for $297. I mean it's ridiculous but I want you to be able to know what's going on inside your body. That's important to me. My passion is educating you. That's why I do the live facebook every single week, the live Facebook meetings where you can ask your questions to me live. I love being in there interacting with you. That's why I'm in the just fix your thyroid Facebook group, actually answering your questions as well. Even in between the lives. This is why I do this podcast and have over 580 episodes. It's because I want to empower and educate you. Labs do that when you have your numbers in front of you. You are already empowered right there. You need the education piece to go along with it and then you are an unstoppable, unapologetic badass right there. So that is what I want for you and that's why we kept it so cheap for you. So click the link below if you want an at home test to know exactly what's going on with your thyroid and your hormones and have it analyzed by one of my team members who trained under me. Right now we have Dr. Tiffany Garcia on staff. She is absolutely amazing. For those of you working with us and working with her, you will know she's amazing. So she will be reviewing your labs and I'm also training a couple other functional diagnostic nutritionists who know labs but they're getting trained under the doctor anyway to know exactly what they're for looking looking at when they look at your labs. So click the link below and do your labs the right way. Follow these instructions that we just laid out on the show to get the most accurate results possible. The information shared on the Thyroid Fixer Podcast is intended solely for informational and educational purposes. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with your physician or other qualified health care provider with any questions you may have regarding a medical condition treatment or before making changes to your health care regimen, including medications, supplements or other therapies. Use of the information provided in this podcast does not establish a doctor, patient or client provider relationship between you and the host or between you and any other healthcare professionals featured on the show. Any medical opinions or statements made by guests are their own and do not necessarily reflect those of the host or affiliated parties. Statements regarding dietary supplements or health related products mentioned in this podcast have not been evaluated by the fda. These products are not intended to diagnose, treat, cure, or prevent any disease. Some episodes of the Thyroid Fixer Podcast may include sponsorships or affiliate links. The host may receive compensation for discussing or promoting certain products or services. Any such sponsorships or affiliations will be clearly disclosed during the episode. All opinions expressed are those of the host or guests and do not necessarily reflect the views of any sponsors. The inclusion of a product or service does not imply endorsement by any healthcare professional featured on this podcast.