← The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
602. Quick Fixes: What to do if you can't tolerate or increase T3
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Could you feel better? Is your energy a 10? Are you at your optimal weight? Do you sleep well? How is your hair? How's your skin? If you say, I am an absolute rock star, I am with you in optimization land, Dr. Amy, then by all means, stay on that T, for only you are rocking it. 99.9% of the rest of us are going to say, like, no, I am not optimal. I still have £10 to lose. I'm still counting the hairs that come out of my head. Right? All of those things. You indicate that you are not yet optimized. And if you're on T4 only, you're not going to be optimized. You need T4 and T3 or T3 only to truly get optimized. 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. Healthy hormones begin with healthy cells. So when we talk about thyroid or hormone health, we usually focus on lab supplements or symptoms. But there's a deeper story happening in your body, and that's one that begins in your cells. Every hormone your body produces relies on healthy, energized cells to do its job. And at the heart of each cell are the mitochondria, your energy centers. As we age, or when the body is under stress, mitochondrial function naturally declines. That can show up in so many ways. Fatigue, slower recovery, or just simply that feeling off. This is where Timeline Nutrition's breakthrough Mito Pure comes in. Mito Pure is a highly pure form of a nutrient called urolithin A, if you've ever heard of that. It's backed by over 15 years of research, multiple human studies, and has been shown to support mitochondrial health, muscle function and overall cellular performance. By helping your mitochondria work more efficiently, you're supporting the foundation of your energy and your long term wellness. I personally found that this deeper cellular approach to health is a powerful complement to everything we do for thyroid and hormone balance. It's not about quick fixes, it's about building resilience from the inside out. If you're ready to support your body at the cellular level, Mito Pure offers a clean, clinically backed way to start. So you are going to go to timeline.com Dr. Amy so that's T I M E l I n e.com forward/d r A M I E and you're going to see the code on there. Dr. Amy 10 D R A M I E 10. But if you want to try the gummies, the Mito Pure, it's actually going to give you 20% off your order. So just go ahead and click that code D R a m I e 10. You'll see it on the page or you can add it at checkout. You're going to save some money while giving new life to yourselves. Welcome to another episode of Quick Fixes where you can get your fix without committing to an hour of your life. I'm here to deliver short quick information that you can implement right now to move the needle with your health. So today we are talking about what to do if you cannot tolerate or you cannot increase your T3 medication. Now you've heard me talk about how important T3 thyroid hormone is. It is the active thyroid hormone. So just to kind of recap, to set the stage when we are talking about treatment for Hypothyroidism or Hashimoto's, 9 times out of 10 you need that thyroid hormone. You just do. Because without it, you are not going to to get the, the relief of symptoms. You're not going to get that metabolic activation, you're not going to feel your absolute best. Because what do we know? What do we know about thyroid medication? We know that T4 only does not work, period. Now if you are in the sound of my voice, you're taking Synthroid, you're taking Levo and you're saying I feel great, fine, awesome. You are in a very, very small percentage. I congratulate you. I would also ask you to reflect and think about could you Feel better? Is your energy a 10? Are you at your optimal weight? Are you able to cheat a little bit here and there with your food? Not on your husband with your food and not gain weight looking sideways at a brownie. Do you sleep well? How is your hair? How's your skin? How's your cold intolerance? Are you pooping every day? If you say I am an absolute rock star, I am with you in optimization land, Dr. Amy, then by all means stay on that T4 only. You are rocking it. 99.9 of the rest of us are going to say like, no, I am not optimal. I still have ten pounds to lose. I'm still counting the hairs that come out of my head. I'm still, I poop every other day. My, my eyebrows are, are non existent unless I pencil them in or get them tattooed. Right? All of those things indicate that you are not yet optimized. And if you're on T4 only, you're not going to be optimized. You need T4 and T3 or T3 only to truly get optimized. And again, laying the groundwork. Medication, thyroid medication. In the T4 category you have Synthroid, tyrosine, levothyroxine, euthyrox, levoxyl. Over in the T3 category you really only have two and that's lyothyonine, the generic or cytomel. And then of course there's slow release compounded T3. That's at a compounded pharmacy. Then we have the middle ground. This is your T4 and T3 combinations. Now of course Synthroid and lyothyonine, Tirasen and cytomel, Levo and lyothyonine. Any of those categories of T4 and T3, we call them biosynth, meaning they are biologically identical to the thyroid hormone that your body makes. Yes, they are synthesized in a lab. They're not taken out of a pig, they're not taken out of a cow. They're synthesized in a lab to be biologically identical or bioidentical. Just like your hormones bioidentical to the T4 and T3 that your body makes. So we can combine those two categories at any point of time. Now, in the middle we have natural desiccated thyroid, ndt. This is what the FDA wants to ban. This is your armor thyroid, your ren thyroid. This is NP thyroid. And it can also be a compounded combination of T4 and T3. Sometimes the compounding pharmacies use the biosynthesis, sometimes they use animal derived porcine thyroid glandular to make their combo product. The best thyroid medication for you is the one that works for you in the combination that works for you in the dose that works for you. So there's no good or bad category here. I'm just laying it out so you can understand. Now, in general, in general, natural desiccated thyroid medication is going to be a more gentle. I'm using air quotes here. Gentle, gentle form of T3. What do I mean by that? It's because it is animal derived and people who are a little bit sensitive to T3, which we'll get to in a moment, people are sensitive to T3. They're going to do better on a natural desiccated thyroid medication. But. And there's a huge, huge butt. That song came into my head. I like big butts and I cannot lie. Okay, a really big butt comes in when we're talking about natural desiccated thyroid. It is 80% T4 and 20% T3. So if you have a reverse T3 issue, if your reverse T3 is above a 12, you're having conversion issues, then even though you're sensitive to T3, that NDT might be too much T4. Or we have to use a really, really, really small amount, like 15 to 30 milligrams. Because anything higher than that, 30 milligrams is pushing up your reverse T3. By the way, I talk about all of this and I guide you through all of this in my new book coming out May 12, the Thyroid Fix. No Nonsense Guide to Fix Fatigue, Fogginess and Fat that Won't Budge. I'm asking you to pre order. I know this is a little side note in the whole conversation pre order this book. So it is in your hands, like May 12, May 13. And you can follow all of this for now, you got to listen to me on this podcast. When you get the book in your hand, you're going to be able to highlight, make notes, is going to guide you in all of this, I promise you. So pre order today. I love you for that. Okay, I'm digressing. So when we're looking at natural desiccated thyroid, if we're using 30 milligrams, you're really only getting 4 or 5 ish micrograms of T3 in that. That's not enough. That's a baby dose. That's the baby dose that I'm talking about doing more harm than good. Coming back to your hypothalamus and pituitary, shutting that down now you're Left with less T3 than you did when you were leaving it up to your piss poor thyroid. That wasn't making enough. But it was certainly making more than that baby dose of T3 that just shut down your own production. I talk about that in the book. So if you're on natural designated thyroid medication and you have a conversion issue and you have to keep that low, we still need to address the T3 issue. So you've dropped down the NDT because it's 80% T4. We still need to address the T3 issue. So what we do with most people is we will add in T3. This is when we're adding in lyonine or cytomel just to change the ratio. We're giving that person a little bit extra T3 while they have the T4 and the, the minuscule amount of T3 on board from natural desiccated thyroid. Some people can't handle straight up biosynthetic T3, lyothyonine cytomil. Some people cannot handle it. They can't handle it. You give them a little bit, you give them 5 micrograms. Like I'm an anxious mess, I'm so sweaty, I'm icky, I'm sticky. All the things that is when you know that you cannot tolerate adding in straight up T3. Now there's another category of people which the answer is going to apply to across the board. It's going to apply to my sensitive peeps that can't add in any T3. It's also going to apply, this whole conversation is going to apply to the people that cannot increase their T3. They're on 20 micrograms twice a day. They go to 25, they lose their minds. They're not sleeping, sleeping, they're anxious. Just that little bit of a bump they have, they have leveled out at as far as they can go. Now for those people, we know that you can tolerate a little bit, right? You're just not tolerating that next step up that next increase. But maybe you know that you have to, you know that you need it. You got to figure out a way. So here are my answers for those of you who cannot tolerate nor increase your T3. So whether you can't tolerate it at all, it drives you nutty bananas. You get anxious, you're a mess. Or whether or not you just simply cannot increase any further. Your T3 medication. This is for you.
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If you are exhausted, gaining weight, you have brain fog, just feel off, and you're tired of doctor hopping and wasting money. Listen closely. So Many women bounce from provider to provider trying supplements, protocols and then functional approaches that never truly address the thyroid. Months turn into years and you're still stuck feeling like garbage, wasting your precious life. So this is why we offer a thyroid and hormone solution call. It's not a lab review, it's not treatment. It's clarity and strategy to determine whether you're a good fit for working with our clinic. We specialize in thyroid optimization and hormone optimization together because they go hand in hand. You can't do one without the other. You have to do them both. We prescribe in all 50 states and if you become a patient, we take care of you from start to finish. Testing, treatment, optimization and ongoing support. You don't have months or years to waste feeling this way. And you shouldn't have to keep throwing money at people who don't truly understand the thyroid and and hormones. So if you're ready for real help, go to doctoramy.com that'S-R-A-M-I-E.com and click book a call in the top right corner to schedule your thyroid and hormone solution call and just let us help you.
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Get your life back and be that.
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Badass human that you are meant to be, that you deserve to be.
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So we're going to go through a couple different options of what you can do try. Some are on your own, some are with your provider. They have to be on board as well. So number one, let's take slow release T3 and let's take a peek at that. Why is it that some people could tolerate slow release T3 as opposed to immediate release in the form of cytomel or L thyronine? It's because when T3 is immediate released, it is used very, very quickly by your body. It has a fast action on the body and this is why we dose it twice a day. So and initially you're going to get a peak, a peak of your T3 at the four hour mark. It's going to come down the other side and essentially be out of your system. Although some is left behind. Essentially be out of your system at the 8 hour mark. Slow release T3 is meant to do exactly what it sounds. It slowly releases through the day. So, so you really only have to take it once a day and you're just getting a small amount pushed out throughout the day. Now some of that is going to be bound to the, the slowing agents, usually a cellulose base where that's what's going to slow the release of the food or I'm sorry. Slow the release of the T3, very, very similar to eating food with your thyroid medication. You're slowing down the absorption, you're slowing down the digestion, you're slowing down the, the, essentially the breakdown of that T3 by adding in a starch, by adding in a cellulose powder to that slow release T3, it gets trickled through the day. So essentially a 10 microgram tablet of slow release T3, you might be getting six to eight micrograms total, and that's pulsed through the day. So one microgram. One microgram. One microgram. Not exact, but just giving you kind of a visual to, to picture as it's pulsing kind of through the day. If you cannot tolerate slow release T3, and slow release T3 can be given in conjunction with NDT, it can be given on top of immediate release T3. So again, this is so nuanced, so personalized. I want you to know that there's always an answer. There's always an answer. And if your doctor isn't giving you a multitude of choices and options and, and is blowing you up, well, Sally, I'm sorry, you're just going to have to suck it up and deal with it. We can't do anything else. This is standard of care. No, you leave, you leave that person because there's always, always, always a combination. There's always something we can do to figure this out. Now, let me back up and say anyone that is very, very sensitive to T3 in the advanced thyroid hormone clinic, we are looking at all of the other things as well. We're looking at your ferritin levels because that plays a role in, in your tolerance or to add in or your tolerance to increase T3. We're looking at your cortisol, we're looking at your stress levels, we're looking at your insulin and your blood sugar regulation, we're looking at your progesterone levels. Because if your nervous system is on edge, you don't have enough of that calming hormone in your body that can play a role to how you essentially react to that T3. So there are other factors that come in and play a role that you might have to look at as well. It's not as cut and dry as, okay, you know, I'm going to wet my hands in this. I just can't tolerate T3. No, you might not be able to tolerate it because of another reason that needs addressed. And that's something you should be working on with your practitioner. But in the meantime, as you're working on that we want to find a way to get that T3 level up so that you can move closer to being an optimization land and feeling your best. So that might mean adding in a slow release T3 to gradually build up your levels. I had a patient once that we did all the things, we checked all of the other factors that come into play when we're talking about T3. We did all the things and the only, only, only thing she could tolerate was slow release T3. So what we did is we just used that and built upon it, and built upon it, and built upon it. So where, when we started, she could not even handle 2.5 micrograms of an immediate release T3. At the end of her optimization journey, I believe she got up to maybe 30 micrograms of slow release T3. And this was done very, very slowly, very gradually over time. So you can see where slow release T3 could be a very, very nice answer to those who are sensitive. Same thing goes to. You're on ndt, we're trying to add in lyothyrene. It's a no go. Okay, let's add in some slow release T3. You're doing well on the NDT, but we can't go up any higher because NDT is 80% T4 and your reverse is already a 1314. So let's add in some slow release T3. That's still going to help to change the ratio. That's still going to get some T3 in your body. That's an option. Now, in addition to slow release, let me also back up, let me say slow release t3 just like what I said, it's very, very similar to, not exact, but it's very, very similar to you taking your T3 medication with food. So sometimes as an experiment, before we actually write the script for the slow release T3, which comes from a combating pharmacy, meaning your insurance is not going to cover it where you might get away with paying a $20 copay for your cytomel or your lyothyronine, you're going to have to pay, compounding pharmacy prices for them making your medication. Now, it's not going to be that much, but you might be looking at $60 depending on your dose or $80 a month. So one thing you can try to see if this is even going to work before your doctor calls in slow release T3 is take your immediate release T3 with a starchy sense food with a cellulose base or some type of a starch that is going to bind to it. Just like the cellulose and the compounding medication bind to it and slow the release. Now, this is not an exact science, so you don't want to rely on that long term because you're not going to get the same dose every single time like you would with a compounded slow release T3. You're going to combine it with different foods. Your digestion is going to be different. So we're going to get varying doses when you just combine it with food. But this is a great way to test it out in the beginning. Here's the other option that you can do on your own if you just listen to all of that you said there's no way my doctor is prescribing slurry. They don't barely even believe in T3. I'm lucky I got 5 micrograms. There's no way they're increasing me. All they will do is increase my NDT and that's going to push up my reverse T3 and make me worse. But I need T3. What do I do? Okay, here's where some emerging evidence is coming out about T2. So T2 we know is a thyroid hormone. It has two iodine molecules on it, two iodine atoms on it. What do we know about T4? It has four. What do we know about T3? It has three. What do we know about T 4 to T3 conversion? T4 has to lose. One has to lose an iodine atom, become T4, three. Okay, well what if T2 grabs one? What if it grabs some iodine and attaches? T2 now becomes T3, now T2 even it, it has a very low affinity to grabbing that iodine, but it can. So what we will see with the use of T2, which is an over the counter supplement, that is what is in thyroid fixer and metabolism fixer. And we're also coming out with a T2 cream within the next month with glutathione in it, which is also very good for the thyroid. What we see with T2 is it does increase your basal metabolic rate, your the amount of fat that you are burning at rest. It is increasing that we know that. It's also working at the mitochondrial level. It is increasing ATP production, is decreasing inflammation, is decreasing reactive oxygen species or oxidative stress. It is browning white adipose tissue. The tyrosine in thyroid fixer and metabolism fixer is improving your thyroid function and is improving how you produce T4 and T3 thyroid hormones. We are also seeing that T2 helps with the conversion of T4 to T3. I'm going to do another podcast diving into the diode nas enzymes and how T2 affects, affects those and actually increases conversion of T4 to T3. So you're going to see a little bit of a bump up in your T3 because it's helping conversion. You're going to see a little bit of a bump up in T3 because it's grabbing an iodine atom and attaching to it and becoming T3. Now on your labs, you might only see it go from like a 2.3 to maybe a 2.8, 2.9. But the, the symptom relief and the effects on your body are going to be 10x that because what they are finding with T2 is that T2, it's a little bit less powerful than T3, but almost as powerful. Does that even make sense? So it has the metabolic power of T3, but it's not as stimulating as T3. So those feelings that you get when you take T3, I'm anxious, I'm jittery, I'm feel like I'm crawling out of my skin, I'm icky and sticky. I have insomnia. Those feelings dampen because T2 is not AS. It's not stimulating it. It really has zero stimulation effect. There are some very, very, very, very, very, very, very, very, very sensitive people that say, well, when I take T2, I get like a little bit amped up. Okay, well then that's temporary. And it's really not even supposed to happen. So you're just like a hyper, hypersensitive person. But most of the time they're not saying that. They're uncomfortably hyped. They're just like, yeah, okay, I, I'm definitely, I got more energy. Well, yeah, that's the ATP production at the cell level. It's giving you more energy. But all in all, T2 doesn't punch you in the face like T3 does. It also leaves your muscle alone. It's only burning body fat. So that's a win. So the majority of people who cannot tolerate T3 can tolerate T2. So this is why we will add in T2 to those people out there, like yourself, listening, who cannot tolerate an increase in T3 or who cannot tolerate T3 at all. You can get the same very powerful metabolic and thyroid effects with thyroid fixer or metabolism fixer as you would with T3. And we're seeing this now emerge. Now, granted, there needs to be many more studies on T2. I don't think we're going to see it because it's not a pharmaceutical drug. It is a supplement. So there's no benefit for a randomized, clinically controlled, randomized placebo, blah, blah, blah study. They're the best of the best. Because who benefits from that, huh? I would. You would? Big pharma won't. So you're not really going to see a whole lot of studies that on T2 unless it's like an N equals 1 or like the, the fixer transformation that we did with an n equals 11. Ladies, where these ladies. And you're going to be seeing more and more of this come out. We took 11 women through a fixer transformation where all they used was thyroid fixer and metabolism fixer. And every single one of them lost a boatload of weight. I mean, I'm talking anywhere between maybe the lowest was 12 pound weight loss in a person that didn't have a whole lot of weight to lose all the way up to like 30, 40, 50 pound weight loss in the ladies that had a little bit more to lose. The biggest thing with this transformation, I sat down with each of the women before they went through this transformation and I said, and I looked at their labs. Now, they weren't patients, so we couldn't prescribe thyroid and hormones to them. Many of them were in menopause, perimenopause, post menopause. We had a cancer survivor that couldn't take hormones. We had women on T4 only and there was nothing I could do. It was good in that it gave us a real and raw trial run with T2 with Thyroid Fixer, metabolism fixer. But I also felt bad. I'm like, oh, I don't know if they're going to get results because their thyroid's in the toilet. Right? I mean, we know even with GLP1s, if someone's thyroid and hormones are in the toilet, it's not going to work. It's not going to work. Well, these ladies push past that. Well, let's say T2 and the ladies effort pushed past that and they all lost weight despite being on T4 only. They're on T4 only. So they broke that barrier, which was super impressive. Now, this does go back to a study that I often reference that was done in rats and they said hypothyroid rats experience the browning of white adipose tissue and thermogenesis, meaning the loss of body fat with the use of T2. What I point out there is that they didn't optimize the rats. They didn't Optimize the. The rats, thyroids, they just let them be hypothyroid, just like these ladies were. And they still experience the browning of white adipose tissue or basically the browning of white squishy fat. They still experience weight loss. It was mind blowing. So all of that to say T2 will work. Even in the most dire of metabolic circumstances, it will work. So that is an option when you cannot tolerate T3 in any way, shape or form, or you are forced to use slow release, which we know you're not going to get the full amount of, add in some T2, because that way you have a fighting chance, at least symptom relief. But you also will bump your T3 just a little bit. And again, I'll be going into this in more greater detail in another deep dive scientific podcast on T2. But this was all stuff that just recently came out that I'm like, ah, the world needs to know because this is a question I see all the time in the Just Picture thyroid Facebook group. We even have some patients that struggle with increasing their T3, and these are the answers that we give them. So I'm giving them to you from me. This is what we do in clinic when we run into someone who is having a hard time tolerating or increasing their T3. Now, of course, and this is not really the purpose of this podcast, there's the whole discussion of conversion. Well, what about pushing conversion of T4 to T3? Yes, yes, yes, yes, yes. I have multiple podcasts on what elevates reverse T3. That is the conversion conversation is when we're looking at reverse T3. What can we do to lower it? What can we do to help this person convert their own T4 to T3 or the T4 that they're taking in their thyroid hormone replacement, pushing that over to T3. So obviously all of the baseline, no DOS supplements, vitamin D, magnesium, you better be taking your iodine. And then we do have a T3 conversion fixer where I combine selenomethionine, little bit of vitamin A. We got some ashwagandha in there. All the things that you need except iodine. I did not put iodine and T3 conversion fixer because you should be taking iodine separately and you should be taking it in liquid form in the nascent iodine form so you can gradually titrate up. I didn't put that in there. That is separate. We have iodine fixer for that. We have T3 conversion fixer. Yes. Do all the things to increase your conversion but the bottom line is sometimes that's just not enough. And even when you increase your conversion of T4 to T3, you still got to get that T3 number up a little bit. You still got to push that. Whether it's slow release T3 or whether it's adding in T2, you need a little bit of help pushing that number up. So if you are in that boat, I truly hope that this helps you, gives you some different options so that we don't leave you high and dry. I never want you thinking, oh my gosh, I'm never going to get into optimization land because I just can't handle T3. We have options for you. Implement them. Talk to your provider. Add in Thyroid Fixer or Metabolism Fixer, whichever you prefer. Thyroid Fixer is in powder in capsule form. Metabolism Fixer is in powder. Put it in your drink, it's flavored form. Metabolism Fixer also acts like a GLP1 and that it controls your appetite. So if weight loss is your goal, food noise is an issue. Add a Metabolism Fixer. But regardless, these are all the answers laid out for you on things you can do to circumvent the fact that you are sensitive to T3. We got to get that that active thyroid hormone up in your body and bring you on into optimization land. Thanks for listening to Quick Fixes and make sure you share this with with someone that you know that is on the struggle bus with their thyron and hormones because this is all I do is teach about this. I want to empower and educate you and give you the tools in your hands so that you can elevate yourself. 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 healthcare 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. 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