← 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
630. How to FIX Your Gut to Fix Your Hormones
00:50:00
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A
Looking at somebody as a whole, it's so important. And part of the reason I wrote the book, because our hormones work in unison, as a symphony, not in silos. And a lot of that hormone production, a lot of the hormone conversion, a lot of the hormone recycling are very dependent on our gut or micronutrients from our gut.
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Welcome to the Thyroid and Hormone Fixer podcast. If you've been told everything is fine, but you're gaining weight despite doing all the right things, struggling with brain fog, mood swings, low libido, or feeling like a stranger in your own body, you're in the right place. I'm Dr. Amy, the thyroid Fixer, and I want you to know right now,
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I see you, I believe you, and
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you don't have to figure this out alone anymore.
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C
We're going to do this together.
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B
But I'm also not here to play nice with bad medicine or empty promises. This show is meant to disrupt the entire health space. We're going to challenge the status quo, connect all the dots other providers miss and give you real practical science back. Tools you can use today. You're not going to get any more recycled biohacking advice. Just truth, strategy, and hope. Let's get you back to feeling like the badass human you're meant to be. Okay, ladies, are you in your 40s or 50s like I am, and possibly wondering why your energy is just fell off a cliff? Well, you're not imagining it. And it's not just thyroid and hormones. A huge part of midlife fatigue happens deeper, like at the cell level because of your mitochondria. We talk about this all the time. Your mitochondria, those parts of your cells that make energy and it naturally declines with age. So I totally noticed this myself. Turned 52 in February. And of course, my labs look good, I'm optimized, but sometimes I just don't feel like the same person, energy wise. So I started taking mito pure gummies. My friend told me about it. I'm like, okay, let me try it. And it's a gummy, so it's not another pill, which is nice. So, Mitrepure gummies from timeline Nutrition. These little bad boys have the clinically proven form of urolithin A, which. That's a whole big science word, right? But basically, what urolithin A is, is it helps to renew your mitochondrial function and remember your mitochondria. Key driver, healthy aging, strength, stamina. And it's just simple. It's two gummies in the morning. So no more pills. No more supplement fatigue. Plus they taste good so you're going to want to pop the gummies in the morning. It feels like I'm supporting my body at the root instead of just chasing symptoms with more caffeine or nootropics. Think of mitopure urithin A as helping your cells make energy basically the way they used to back in your 20s and 30s. So if you are experiencing midlife fatigue and it's dragging you down, this is a great place to start. Go to timeline.com T I M E L I N E just like it sounds timeline.com forward/doctor Amy-R A M I E to get up to 3939 of your Mito Pure Gummies. So that is timeline.com forward slash Doctor Amy I need to talk to every woman who's been told your labs are normal while your body is screaming at you and rebelling against you. Fatigue, brain fog, the weight that will not come off, mood swings, hair loss, feeling dismissed, frustrated and confused. I get it. And that is exactly why I wrote my new book, the Thyroid Fix. The no Nonsense Guide to Fix Fatigue, Fogginess and Fat that Won't Budge that just says it all is and it is now available for pre sale. So I need your help to spread the message. I am giving you an ask as my listener and a promise at the same time. If you pre order the thyroid fix, my promise to you is to continue delivering all kinds of free advice, information, content, education, empowerment. Because that's what I love to do. Whether it's here in the Just Fixture Thyroid Facebook group or I'm on live.
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I will give you everything I possibly
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can if you do me one favor which will be a favor for yourself as well and pre order the Thyroid Fix.
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Now.
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This book is not another list of supplements, vague advice. It's not a diet plan. It's not filled with recipes. It is a clear, honest guide. It is the Thyroid Bible. It is the last thyroid book that you will ever need because it teaches you how to read your own labs. No other book has done that. It teaches you what medication and dose you need. No other book has ever done that. It will help you to understand why you are being misdiagnosed while you're being undertreated and why you can't talk about hormones, weight loss or menopause without talking about the thyroid. I called it Thyroid Bible because like I said, this is going to be the thyroid book of the next few decades. When you pre order, you're not just supporting me, you're telling the publisher this message matters and it needs to get out to the world and it needs to get into the hands of women who have been ignored for far too long. So will you go to thyroid fixbook.com and pre order a copy of yours today? It'll be shipped to you on May 12th and you will get free entry to our all day live event where I will be there answering your questions live, teaching live and bringing in amazing guests for you to also connect with and ask your questions too. So thyroid textbook.com pre order yours today.
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C
If you've been listening to this show for any length of time, you know the truth. Your metabolism is hormone controlled, not calorie controlled. Your thyroid runs the show from head to toe. It runs the show. Your hormones run the show. That doesn't change. But here's what we don't talk about enough and I want to dig into this today. Your thyroid and your hormones don't operate in a vacuum. They have to work through a system. And when that system, your gut is inflamed, leaky, dysbiotic, sluggish, however you want to call it, your thyroid and your hormones can't do their job no matter how perfect your protocol is. Today's guest is my friend and colleague, Dr. Cassie Smith. Her book is called Fix your gut, Fix your hormones. We, we love the word fix here and she's about to show you the connection that takes your hormone protocol from working okay to working brilliantly. So let's get into it. You know, I love it so much when I have a like minded individual. And to make it even better, a like minded individual who is a powerhouse, badass woman who knows what the hell she's talking about when it comes to thyroid and hormones. So that is a huge bonus for the show today. Dr. Cassie Smith, thank you so much for coming on. We're going to be talking about your book, Fix your Gut, Fix youx Hormones, which is right on point. Love the title, straightforward. We know what it's about, we know how important it is. But I just, I love having conversations with you because we are so alike. We're so aligned in our view of the world and specifically, you know, thyroid hormone conditions, all of that. So welcome to the show.
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A
Thanks for having me.
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C
Absolutely. So we've already had some really great conversations on your show and off air, but I want to dive into because you are a clinically trained endocrinologist. You mentioned when we were recording for your show, you mentioned that you had gone through this top level training, the best of the best in the country on going deeper into endocrinology, into thyroid, into hormones, and not once did you learn about key markers for thyroid, about using T3. I mean, that just blows my mind. So what catapulted you to come to this side, to learn the functional medicine aspect of endocrinology, to really be able to help the people that you do?
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A
Well, those are great questions and thank you for the sweet intro, Dr. Amy. But I think, yes, like we discussed, I think it is a travesty and something that has to be fixed with traditional healthcare. Like the education piece, right? And people say lots of different things, like, is it driven by pharma, Is it driven by ignorance? It doesn't matter what it's driven by. Like, the excuses need to stop. We have really, really sick people in this country. And I talk about it in the book, in the very first chapter, give you alarming statistics about how many millions of people are obese, are overweight, are insulin resistant, are infertile, are spending all their life savings on health care when they get into their 50s and 60s, how medicine is supposedly progressing. And we're having all these breakthroughs in medicine, yet we're sicker than we've ever been, we're spending more money than we ever have on healthcare, and we have nobody giving us any answers. They're just like feeding us more poison and more garbage, to be honest with you. And I got out of training now 10 years ago, and none of that training has changed, despite that fact that we know more. And when you know more, you should do better, right? But we're not doing that in medicine. And so it's really frustrating. Like, why? And I've asked the question, too. I've asked the question at the national level, like, why are we still teaching endocrinologists and primary care doctors or anyone that T3 is. Like, why are we not teaching that T3 is important? Why are we teaching that TSH is still the end all, be all? And it's because the Endocrine Society guidelines have not changed for thyroid disease since 2012. That's insane. Like, they haven't changed. And so I think, first of all, if you're listening to this podcast, then obviously you're very interested in thyroid disease. You need to be asking those same questions. These are questions we need to be asking everyone. Like, why are we not demanding better for thyroid patients, but just patients in general? Right? And so I came about this and interested in functional medicine and writing this book as a patient myself, just like you. It. It came from this Almost just like the saddest place I ever was. Like the shell of a human being. I didn't even know who I became because I was so sick. And I went to all these different doctors and I got medically gaslit into thinking like, well, you're fine, it's all you. And it wasn't me. It was that I had Graves disease. And then they wanted to ablate my thyroid and then they wanted to surgically remove my thyroid. And thankfully I had a lot of questions like, well, why is this happening and what would happen if I did this? And so I refused to do it. I got labeled as the non compliant patient because I wouldn't take the ablation, right? And I wouldn't do the surgical treatment. And then I became hypothyroid because my thyroid burnt itself out from stress and from poor medical treatment. And then when I was hypothyroid, I had lots of other questions and I saw endocrinologists and I'm like, why do I not have eyebrows? And why is my hair falling out? You know, like you said, like, if I keep washing my hair, I'm going to have literally zero hairs left on my head in the next two to three months. We got to do something about this. Not to mention I'm cold and fat. Like, that's one thing. But, like, literally I have no hair and I have no eyebrows and I can't get my rings off. And I'm like this doughy human who like, can't process thoughts correctly. And I'm a very educated individual. Something is wrong here. And they're like, no, your labs are fine. Right? Because they were looking at my tsh. And so through that pain and suffering and through the frustration of myself not getting better and my patients not getting better, despite me doing exactly what they taught me in fellowship, to a T. Because I was like, I want to help people like me. I did exactly what I was taught to a T. In the highest form of education we have in the United States as a board trained endocrinologist, nobody got better and I didn't get better. So I was finally like, you know what? Done with this. Like, done with this. We're going to do better. And I started looking at the gut and I never turned back and I'm better. And hundreds of, or not hundreds, tens of thousands of people are better because of the people I've taken care.
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C
Oh, my gosh. Amazing. And what, what really fascinates me, you really are the first endocrinologist that we've had on the show that I have seen break out of the conventional system and that that whole model of TSH and T4 only. And really, it was your own pain to purpose story. You were forced into it. And thank God you had a thyroid problem, because I don't think without that you would have gone as deep as you did to explore the gut thyroid connection to be able to help this many people. So I'm kind of happy that. That you got the shaft and in conventional medicine, because that makes you just that much better of a provider which we so desperately need. We so desperately need. So I'm happy you're doing what you're doing. Okay, so let's unpack this thyroid gut connection. You know, I talk about it on the show, but not in depth like we're going to today. And I think it's really important for the listener to know that because it's so easy to get into. We talked about on your show, it's so easy to get into these patterns of, you know, I'm just, I'm going to go over here and I'm going to fix my adrenals because there was an Instagram influencer that said that that hypothyroidism starts in the brain. So all I need to do is take his master class and put some adrenal fairy dust on me and all will be well. Or they're over here going, you know, I'm going to go to these cookie cutter hormone clinics, right? The ones that are on every corner, and you can get your hormones in a box for $129 and all's going to be well because I'm going to get my hormones. But you're like, no, no. Time out there is a lot more to look at. And there is a huge gut connection there that the master classes and the adrenal fairy dust and the box hormones are not looking at. So let's start there. Where would you start in describing that enormously important connection between our gut and our hormones?
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A
So to start, I love that picture. The mastercat class, adrenal fairy dust, and then the hormone love in a box. Yeah, Dumb. The corner. I love that. Because you and I both know that we deal with people who do that every day, and they're the most difficult to treat because they have been treated inappropriately or given the wrong concept of how to heal for years. And that just continues to create more and more damage. Right. And also to your point of not compartmentalizing everything, Right. Like looking at somebody as a whole, it's so important. And Part of the reason I wrote the book, because our hormones work in unison, as a symphony, not in silos. And a lot of that hormone production, a lot of the hormone conversion, a lot of the hormone recycling are very dependent on our gut or micronutrients from our gut. And so if you don't understand that, you can give somebody all the adrenal fairy dust in the world, you can give them all the hormones in the world, you can give them hormones to the point of them being unsafe and causing significant side effects, which then cause people to say bad things about hormones. And then we have this terror of oh my gosh, hormones cause. Fill in the blank. Because people, Susie and Sally, who went to the hormone doc on the corner in the box, got too much hormone and they had a bad side effect. And then they extrapolated that to all hormone use, right? And so it is so important for people to understand when they are going to get their hormones looked at and evaluated. They go to somebody who understands all this and somebody who at least understands that your gut is important for this. Stress is important for this. This because it's not good enough anymore to just check people's hormones and say, oh, you look normal or this is abnormal. Let's just give you a hormone. We need to understand how that hormone is broken down in the body, what co factors it needs to work, how it actually gets into the cell to be utilized, and then how it's recycled and left in the body. If you don't understand all that, when somebody does have a side effect or doesn't feel better or we're not getting where we need to get to, you're not going to understand where it's broken, right? Where the uber system left the hormone or the passenger, how do we go back and get the hormone and get it into the cell where it needs to go. So all that is so important and that's part of why I wrote the book I gave everyone I laid out. What is your microbiome? How does it affect your hormones? Each hormone has a chapter. How does this hormone work with your gut? How does your gut work with this hormone? If this hormone is disregulated, how does it change all the other hormones in our system? Right? And then how do these processes develop diseases? Like what is going on with our hormone production? Lack thereof, lack of conversion, that causes us to have pcos, that causes us have infertility. Infertility is the highest it's ever been. How does know what's going on in menopause? Why are we gaining Weight. And so all these things are just really important. And I got sick of explaining it over and over and over to people and doctors who just didn't understand because it took an hour for hours to do correctly. So I wrote a book.
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C
There you go. And people can buy the book and give it to their doctor too, so maybe they can learn. So we're not going to give away everything because I want people to go out and buy the book, but I want to highlight a couple different areas, a couple different gut and hormone connections. Of course, let's start with the thyroid, since that's what we talk about a
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lot on the show.
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But we, we love our sex hormones too, so we're going to dive into that as well. Let's just start with the thyroid. Now, I talk about the diode enzymes manufactured in the gut. Obviously, if we don't have enough of the right ones, we're not going to convert our T4 to T3 properly. And if we have too much of the wrong ones, we're going to push that to reverse T3 anyways. Can you break that down for people? What is that? The gut thyroid connection? I'm sure there's more to it than just the diode enzymes, but what is that gut thyroid connection that we need to be looking at?
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A
Yeah, that's a great question. And to your point, those enzymes are made, and I like to say maintained in our gut by certain bacteria, right? So our gut bacteria is balanced. They're, bacteria that, you know, absorb nutrients. There are bacteria that help us digest food. There are bacteria that help us convert enzymes. And so there's a lot of different. There's bacteria that are helping make sure that our immune system stays intact and nothing is harming us. And so all of those bacteria have to play in the same sandbox together. The problem is if we're overly stressed, if we're not sleeping well, if we're eating too much carbohydrates and, you know, too much sugar and we get this dysregulation of those bacteria because also all those bacteria have to eat, right? So I think the other thing that's important to point out here is our good bacteria eat things like fiber, very nutrient dense foods. Our bad bacteria that are in our gut, they eat sugar and carbohydrates. So if we are feeding our body a lot of sugar and carbohydrates, we are fueling these bad bacteria that are in us that are there for certain reasons in small amounts, and they outgrow in the sandbox. The good bacteria that are supposed to be getting our micronutrients, that help our diagnose enzymes, convert T3 to T4, that help us recycle our estrogen and make sure that we're not in, you know, have too much estrogen floating around and going down the pathways that cause cancer. And so if this sandbox gets out of balance and we have all the bad guys, you know, the big kids in the sandbox that are trying to throw the little kids out of the sandbox and. And be mean and unruly, then now we're not converting our thyroid hormone correctly. So even if we're taking thyroid hormone, right, if you're somebody who's taking some T4 or your body's making T4 and it needs to convert to T3, or even if maybe we're getting T3, sometimes that T3 can't even work in the sandbox because we've got all these bullies, all these bad bacteria that are not allowing it to do what it needs to do. So one of the issues is the bullies are keeping the T4 from converting to T3. But the other issue with your thyroid in your gut is if we have a lot of bullies and we have a lot of bad bacteria, that bad bacteria releases something called lipopolysaccharide. This is a, you know, something that floats around our body and it causes little holes in our gut. So it would be like the bullies going and kicking the side of the sandbox until the sandbox has little holes in it. And now the sand is leaking out of the sandbox because of the bullies. When we have too much bad bacteria and too many bullies and we have lycopolysaccharide being released, then our body's like, oh, my gosh, we're being attacked. What is going on? Right? It's like somebody wants to come and fix the sandbox. The problem with the lipopolysaccharide and the holes in our gut is this releases cortisol, which is our stress hormone, because our cortisol's why. Why is food now leaking out of. Out of the same. Why is sand leaving the sandbox? Why is food leaving the gut? And so it drives up our cortisol, it drives up our insulin, and when our insulin is high, it causes inflammation, as does cortisol, when we have a lot of inflammation. The problem is, now that we have inflammation, even though we have T3, some of it's going to convert to reverse T3 because our body thinks, oh, my gosh, we're under attack. Right? You talk about reverse T3 in your book too. So some of our free T3 is now going to convert to reverse T3. But the other problem is when we have a lot of inflammation, all of the cells that need to take T3 in their doors that the T3 go through become locked. The inflammation freaks them out. It's like there's a burglar. And so now we're locking the doors of all of our cells. And so even though we're pushing T3 into the body, the T3 can't get into the cell because of all the bullies and the bad guys in our gut. And so then it becomes an issue of, you know, we've all had those patients where it's like, their labs look great, their T3, you know, maybe their T3 is four, it's four and a half, it's five. And it's like, why do you have every symptom of hypothyroidism? Your T3 is adequate in your blood? Well, it's because the door to the cell where the T3 needs to go into is locked. And it's locked a lot of times because of stress, because of bad bacterial overgrowth, because of insulin resistance, because of birth control, lots of different things. And so that's where it's really important to understand a gut connection. Because if you don't understand that and you go to a provider that doesn't understand that, and maybe you're lucky enough to get a provider that's giving you T3, they may just keep giving you tons and tons and tons of T3, but if your T3 can't get into the cell to work, you're still going to be hypothyroid.
- [22:38]
C
Oh my gosh. I just, I get so geeked out when I have people on the show that are so like minded and then they say things that I would normally say and I'm like, yes, they're backing me up on. This is awesome. So I always use the analogy of a bouncer at the club, like the bouncers outside the cell door telling T3 it can't get in. And I love the fact that you just mentioned that you can actually see that free T3 look really darn good. I mean, like pretty, like actually optimal. But it's because it's like it's backed up. Yeah, it's floating around in your blood, but it's not actually getting into the cell to do its job. So I love that you mentioned that because how many providers will Just look at that free T3 and go, well, I don't know. Looks good to me. Like, what are we going to do here? And that person is still struggling. So that's, that's beautiful. That is beautiful. Okay, so when you are starting to look at the health of the gut and looking at how does this play a role in where a person is at thyroid and hormone wise, balance wise, what tests are you doing for the gut? Like, what do you really like to look at to get an accurate picture?
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A
Yeah. So I think this is a great question. And, and you know, to your point too, like when I was the sickest I ever was, and I first was like, I'm going to take T3, right? Like, I'm going to. And I started taking T3, my T3 levels were like 5, 5.2. Like, they looked wonderful. And I was like, I'm still hypothyroid. Like I, I still don't have hair. Like, you know, and, and to the point I did it not knowing anything about my gut. Like, I was still insulin resistant. My gut was a train wreck. Little did I know I had Candida and I had bacterial overgrowth. And so, yes, to your point, going back to the labs, because I know you harp on this too. Like, sometimes your labs can look even like the doctor was like you. Your labs look better than they should look. Like, why do you feel like this? Well, it's because my bouncer was not letting the T3 in, right. My, my doors were really locked. So I think it's important for people to understand that. And so when that happens and your doctor tells you your labs look great, right. You shouldn't be having those symptoms, but you are, then you do need to ask more questions like we were discussing. You need to, okay, well, is my insulin high? Is my cortisol high? What is going on in my gut? And I think your gut is a great place to start, especially if you have more than one poor hormone symptom. Right. Or more than one thyroid symptom, especially if you have thyroid symptoms plus, you know, weight gain. Just different things. Your gut is a good place to go to because your gut regulates all your hormones. And so the testing that I like to use right now is a GI map. There are tons of tests out there. And I have a lot of people who, you know, want to debate this with me. And it's not because it's necessarily the best end all, be all test. What I like about the GI MAP is it is a DNA PCR test. And I feel like it gives you enough information in a condensed and concise form that you can make 90 to 95% of people way better. Fix them. But it's not so overwhelming that people are like, I don't even know what to do. Right. There are stool studies out there that are 17 pages, 22 pages. They're so in depth, and you feed them into ChatGPT and. And somebody's, like, so overwhelmed because it takes them three hours to read what it says. That is not helpful to people who are already stressed out and very sick. So in my opinion, we get a lot of bang for our buck and make 95% of people better with a GI map. And so that's what we are using right now, our GI maps. And I really like them. And so I talked about that in the book. I said, hey, if you want to order your own stool test, here's how you do it. Here's how you interpret it. I go through exactly what I'm looking at, what you know, because it is important information to have. And maybe you can't afford to work with a functional medicine coach and pay $8,000, you know, but at least you could do this test. Just like you talk about blood, work on yourself, do a gut study on yourself and see what is out of balance, what you know. So that way you have an idea. Is it my gut, or do I need to be looking at something else?
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And I. I'm right there with you.
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C
I love the GI map. I think it's fantastic. It's easy to understand, and. And. And we're so similar in that. Yes. I love that you are teaching people how to read their own labs, because oftentimes, and I'm sure you've seen this too, people will go out and they'll order a functional test and. And the provider won't even go over it with them. They're literally left to inter. I'll be like, didn't so and so go over this with you? They're like, no. Like, well, then you better learn how to interpret this, huh? And that's what you're doing in this book. You're literally putting the power into the patient's hand to be able to look inside themselves and understand their body, because at the end of the day, you know your body best. You know it better than any white coat out there, and you should know how to interpret these tests so you can have a deeper understanding. Now, you might need that doctor. You might need to work with Dr. Cassie to get to that next level. But you starting with. With the understanding of what's going on in your body, I think is so, so beautiful. And I love the fact that you teach people that in the book.
- [27:42]
A
Yeah. And same thing with your hormones. Just like you. Like, I give you a list, like, here's a list of your hormones. This is what it should look like. If it doesn't, you know, in each chapter, it's like, okay, well, if your reverse T3 is high or your free T3 is low, why is that? I mean, do we have an insulin issue? Do we have a cortisol issue? Do we have a stress issue? Do we have a sleep issue? Like, just lots of information. Because to your point, like, maybe, you know, you. You don't have the money to go to a functional medicine provider, but you at least deserve to understand what's going on in your body and then to have some simple steps of, how can I start to fix this? And the whole last chapter is just like, hey, here's free things you can do. These are all free. This is how you fix your gut for free. This is how you start to fix your hormones for free. And it's the unsexy stuff that nobody wants to talk about and the stuff that doesn't get a million plays on social media. And this is why you have social media influencers trying to sell you fairy dust, because they get paid to do that. And people are like, oh, it's the magic pill, right? But you don't have social media influencers talking about, you just need to sleep more. You really need to make sure you're not stressed. You need to give your body nutritious food, because nobody's going to listen to that, nobody's going to watch that, and nobody's going to make any money on that. But that's actually where you have to start.
- [28:54]
B
Like, do you want to burn fat while just sitting around? Do you have extra weight to lose? Do you want less inflammation? Do you want to reduce your oxidative stress? Do you want to improve your lipid panel, maybe become more insulin sensitive? And once again, burn fat while you're sitting there at rest at your desk or on your couch watching Netflix. Well, now you can, with the power of T2 that is in Thyroid Fixer. Now, Thyroid Fixer is not just for those with a thyroid problem. It's for anyone looking to lose body fat to improve their metabolism to have better energy. Thyroid Fixer actually works at your mitochondrial level, so it is stimulating your metabolism. It's also activating ATP, which gives you more energy. Nice and steady through the Day. Here's the other really cool thing that Thyroid Fixer does. It turns on a gene that prevents fat from accumulating all over your body. So that means, yeah, if you slip up and you have the Oreo cookie or the sweet potato fries, which are my two favorite, they're my downfalls. That is not going to put extra fat on your butt, your hips, your thighs and your abs. Oh, and your arms. You don't want those jiggly arms. So why don't you just improve your fat burning potential and actually turn on a gene that prevents fat from accumulating on your body with the power of Thyroid Fixer. So as a listener of the Thyroid Fixer podcast, your first time purchase, you can use the code listen 20 L I s t e n 2 0. We'll put that down in the show notes.
- [30:36]
C
And if you've already purchased it, but
- [30:38]
B
you just want to save a little something, something extra, then use the code listen 10L I s t e n 10 and grab some Thyroid Fixer. Stock up today because it will help you burn extra body fat. And who doesn't want that?
- [30:54]
C
I know, isn't that amazing? It's like, really, all the free stuff is the most impactful actually, you know, beyond the $10,000 hyperbaric oxygen chamber and your $5,000 red light, like, no, how about you just sleep and, you know, do a couple other free things? So we're going to, we're going to leave that carrot dangling. I'm going to ask you that question at the end so we can give the listeners a little nugget of what you're talking about. But I want to go into gut and estrogen too. That's a huge correlation right there. And like you had mentioned earlier when we're talking about the, the box step, hormones on every corner, you know, you said something that the problem is, is that this can actually do harm. And about a year ago, I was diagnosed with uterine cancer and it was estrogen receptor positive. Now, we know that that doesn't mean that estrogen necessarily caused it. But when I looked a little bit deeper into my genetics, into my Dutch report, it turns out I don't process my estrogen very well and that could very well be tied back to the gut. I'm gonna have to pick your brain, have you look at my GI map to see if there's any correlation there. But let's talk about that gut estrogen connection because I think so many women are just adding in hormones willy nilly or they're going to the hormone clinic on the corner. And they're actually not. They're becoming either estrogen dominant or they are potentially doing harm. We also know that at estrogen dominance comes back and increases thyroid binding globulin, which is now going to affect your thyroid hormones too. So let's talk about gut and estradiol.
- [32:36]
A
Yeah, that's so important. So there, you know, we actually have something in our gut called our estrobolone, which is a specific type of bacteria, and their only job is to help metabolize and process estrogen. So important, right? Like these bacteria are crucial for estrogen metabolism in your body. And what does estrogen do for our body? Well, as women, it's our superpower. Like, it's not that we want to take it away from women, we want to make sure that we're giving it to women and that we're metabolizing it correctly because it's a superpower. It supports our bones, it supports our brain, it supports our breasts, it supports our skin, all of you know, our vaginal secretions. It helps lower our cholesterol, it helps keep us from getting heart disease. I mean, it is a phenomenal hormone. It actually helps with metabolism as well. So like a lot of women that develop the, I call it the inner tube around their gut when they go through menopause, some of that's thyroid related, but a lot of it is your estrogen. So people think, oh, estrogen makes you gain weight. That's not true. Estrogen, if your estrogen is balanced and your estrobome is right, it's actually going to lower your insulin, lower the inflammation in your gut. So it's very important. But if your estro is not balanced correctly and you don't have those bacteria that help digest and process those hormones, then we get into an issue. And so you mentioned Dutch testing. So Dutch testing is, you know, is something you can do if you're worried, like, hey, my estrogen isn't metabolizing. But all Dutch testing is doing is it's literally looking at the metabolism of estrogen through your liver, right? There's phase one, phase two, phase three, detoxification of hormones in our liver. And we need certain enzymes, coenzymes, and things that happen in each of those stages. So basically, when we take estrogen or we produce estrogen, whether it be from our ovaries. Well, our ovaries, because our adrenal gland makes testosterone, but our ovaries produce estrogen. So when we make estrogen or we take estrogen, estrogen, circulates through our body. It goes to the cells it's supposed to, and it, you know, it does what it's supposed to do in that cell. It helps our skin, it helps our breast, it helps our cholesterol. And then once that the cell has taken it in, right, it's opened the door, it's gone in, and then it's come back out and it's ready to be re. Re circulated or metabolized, right? It goes to our liver, and our liver starts to break the estrogen down and package it up in a way that it can leave our body safely. And this happens all the time. And so these steps start to happen in our liver, which again, are very crucial to making sure we have certain micronutrients. Methylated B vitamins are very important. If we don't have good bacteria in our gut that can absorb these micronutrients, we have a problem because then it gets. Our estrogen gets to our liver, and our liver is like, I don't have what I'm supposed to have to package you up. Sorry, just move along, right? And so our, our estrogen, when it goes in there and it's done, it's almost like our liver has to take pieces off of it and then wrap it up in a nice bubble wrap and then send it out through our bile into our gut. And then it is in our gut and we excrete it in our stool. And it's like the estrogen is rolled up and packaged and ready to leave, right? Because if we don't do do that, then the estrogen can go down different pathways through our liver and it can become something called estrone. And we don't want that because that's a bad estrogen. Estrone stimulates our breast and stimulates our uterus to proliferate inappropriately and cause cancer. And so when this happens in our liver, assuming that our bacteria are working correctly and we have all the micronutrients we need and everything is working in our liver appropriately. So our liver is also very important for estrogen metabolism, right? We have to make sure we have glutathione. We have to make sure we don't have fatty liver. So the estrogen gets packaged up in our liver, it gets wrapped up in little Saran wrap, kicked back out into our gut. It's on our way out of our body in our gut, our estroge or the bacteria in our gut. Calcium D glucuronidase is very important for this too, kind of help just push that package estrogen through our gut and then out into our stool. The problem becomes, if our estrobolome is imbalanced and we have a lot of those bad bacteria, the bullies in the sandbox. The bullies in the sandbox go picking at the estrogen. They go picking at the wrapped up estrogen, right? They're like, oh, I wanna make a little hole in you. I wanna see what's in this package. I wanna. And so it starts unraveling the package of estrogen. And when that happens, then what happens? Well, now the estrogen is free to move about the cabin. So it starts moving back through our GI tract. And then now our GI tract has holes in it from all of our bad bacteria. And so the estrogen starts leaking out of our gut and it goes back into our bloodstream in the back flow form, like the packaged form that was ready to leave. So it's like the utilized, used up form of estrogen is now circulating into the body. And a lot of times it's in the form of estrone. And then that estrogen, instead of going and helping our bones and helping our brain and helping our heart, what it does is it goes and it proliferates tissue in our breast and it proliferates tissue in our uterus. And then we end up with cancer. And so it's not the estrogen's fault. It's the way your body and your environment processed the estrogen. And if you don't understand that and you just keep dumping hormones into people because you're like, oh, you're not feeling better, I'll just give you more and more and more estrogen. The problem is your body can only metabolize and process so much estrogen. And so then we start to get a backup in our liver of how we're doing that. And so we're shunting estrogen into this unhealthy form over time. And so it becomes a problem.
- [37:50]
C
Yeah, yeah. No, thank you for going in depth. And I love your analogies because I'm always using analogies because that really drives home the importance. This is so much more than. Than the aesthetics, right? We always talk about the aesthetic part. The weight. The weight you can't lose. The hair loss, the loss of your eyebrows, right? The dry skin, the wrinkling from low estrogen, the decline in muscle mass that sucks when your body comp changes. But what about the diseases of aging? What about the chronic disease states that we're not thinking about that we're not speaking about enough. So even okay, for thyroid, we know that low Thyroid function or a non optimized thyroid, increases your risk of Parkinson's, increases your risk of Alzheimer's, increases your risk of cardiovascular disease. And you know, speaking of some of the IG influencers that drive us bananas, I saw one that was using this as clickbait, of course, saying, well, Synthroid causes cancer. I'm like, no, it doesn't. Like, Synthroid is not a carcinogenic medication.
- [38:58]
B
Right?
- [38:58]
C
It's not going to cause your body to mutate its cells and turn cancerous. What they're saying, but not saying because they want you to click, is that if you're on T4 only, your immune system might not be working and surveilling at, at the best, you know, capacity that it has. So it might miss some of those cancer cells that flip over because your immune system isn't working that well. Okay, Same thing that you're talking about with, with the estrobolo, like, yeah, okay, you're going to gain some weight, ladies. But hey, what about fueling cancer? Does that wake you up enough to maybe pay attention to your gut? You know, if it's not the weight that gets you, if it's not the hair loss that pisses you off enough, could it be maybe the protection against cancer that you might want to think about before you throw hormones at your body? Like, I, I love that, that you tie that in. Because I think it's important to talk about chronic disease states in the gut as well.
- [39:54]
A
And I think it's important for, you know, these pop up hormone clinics that pop up. I mean, I'm sure they have your best interest in heart. Like, we do know that hormones, again, estrogen is so beneficial for your heart, lowers your risk of heart disease, lowers your risk of dementia, you know, helps your skin. I mean, there are, there are disease processes that get better with hormones, but if you don't understand how to give the hormone in the right dose and make sure that it's metabolized correctly, you can really hurt someone. And, and there are easy ways to look at this, right? I mean, there are blood tests. I talk about it in the book. There's an estrone level. I don't understand why we don't check estrone levels in people, right? Like it's a blood test. Oncologists don't even check these things. Like, if I had breast cancer as a woman, I would be like, what is my estrogen level? I want to know where it is. And then after I treat this, I want to make sure my estrogen level is never above 30. 30 again. Right. Because me personally, if I get breast cancer, I'm going back on estrogen because I understand the benefits and I understand that estrogen didn't cause the breast cancer. It was the way my body metabolized it. I've got an internal issue with my environment that I need to fix. But I want to know if I'm not metabolizing the estrogen correctly. Well, you can know that you check an estrogen level, you do a Dutch test, you look at a gut study. Right. And so just crazy to think that like, but if you're a pop up hormone clinic and you don't understand this, you can really start hurting people. Right? And so that's not fair because then those are the people who go out and say, oh my gosh, you know, hormones caused my cancer. And then we get all these people scared to take hormones. And it's just, it's not factual. It is how your body processes the hormone that causes the cancer and the environment within you. And so, and there's lots of things to be said with, you know. Yeah, did you have a liver issue? Did you have, you know, was it the birth control? Birth control is probably messing with your liver and your glutathione for a really long time. So then was your body not metabolizing your estrogen correctly and maybe you were shunting more down your estrone pathway. Right. And your estrogen was metab. Was, was making your uterus turnover. And so it's not the hormone, it's how your hormone was metabolized. And to your point, we don't know that without looking at the gut. We don't know that without looking at Dutch testing sometimes we definitely don't know without at least testing blood levels. And so to your point, I, I say this a lot. Like if you don't care about your vanity and you don't care about how you feel and you don't care about your metabolic health, at least care about your gut because that is the end all be all of how your hormones are metabolized, how your vitamin D is absorbed. These are all really important things with, do you develop cancer or not?
- [42:21]
C
Yep, absolutely. Now we always hear about the gut is your first line of defense, it is your immune system. So that's going to tie into autoimmunity. Correct. Do you talk about that in the book with the gut and let's say Hashimoto's or other autoimmune conditions?
- [42:38]
A
Yeah, that's a great question. I do mention that in the thyroid section about Hashimoto's and how Hashimoto's cross reacts with gut issues, for sure. And so yes, when you have this chronic low grade inflammation from your gut, from dysbiosis, from bad bacterial overgrowth, for, from the fact that you have a leaky gut and holes in your gut, from the fact that you no longer have an immune system that can. Just like for instance, when people eat things and get, you know, food poisoning, something like that, or just, or viruses in general, your immune system, 70% of it is in your gut, right? So it is in your gut and it is there and it is ready to help you. Because most of the things that get into our body that can harm us come actually through our gut. Like we accidentally eat something that hasn't been washed or something crawls in our mouth while we're sleeping. I mean, all sorts of crazy stuff happens. But our immune system is around our gut and being trained in our gut so that anything coming through our body that's not supposed to be there, it can attack and get rid of viruses, et cetera, right? Comes through our nose, comes through our mouth. When you have a bunch of commotion and dysbiosis in your gut, all the bullies in the sandbox, your immune system, your cells that are supposed to defend you, your soldiers, they can't see there's smoke, there's flames, like they can't see what's coming. Also, they get tired. If they're chronically being stimulated by this inflammation, they never get a break, they never get to rest. And so when there actually is something that's going to come and harm them, it's like, do we even have enough army men to deal with this or is this even real? Right? We've been stimulated so long, it's like the girl who cried wolf, the boy who cried wolf. It's like I've been stimulated so many times, every time you eat and I don't even know if this is real. And so there's so many issues with your immune system too because of the chronic low grade inflammation from stress, from high insulin, from leaky gut. And so that starts to cause issues as well. And then when your immune system isn't functioning well and we eat things like gluten, the antibody that attacks gluten in people who eat it, that have Hashimoto's, you know, that same antibody also attacks our thyroid. And so I talk about that cross reactivity and how when we have an antibody floating around that's attacking gluten and attacking our thyroid, that also makes our Inflammation worse. And so it's this big nasty process.
- [44:55]
C
Nasty circle. I know. It really is. It really is. Now I know. And again, I'm leaving people hanging because you just got to go get the book. But this is a question that I get a lot as well, so I'm going to ask it to you. Is it possible to actually heal your gut? And maybe for those people that are like, I don't want to be on thyroid medication, I don't want to be on hormones, and I get it. I mean, we can talk all day about the benefits of thyroid hormone and bioidentical hormones, and at the end of the day, that's their choice to go on or not go on. Is it possible to truly heal the gut and get some level of balance and happiness to these people that want to, let's say, avoid the hormone replacement therapy?
- [45:40]
A
Well, you're definitely going to feel better if you have a functioning gut than if you don't. Right. I mean, the other reason we have a gut is just to detoxify and clean our body, too, right. Between our liver and our gut, how do you get rid of toxins? You sweat and you poop. Right. And so if you're somebody who's listening to this and you don't poop for whatever reason, hypothyroidism. I mean, if you don't poop every day, you're not getting rid of your toxins. And so to answer your question, yes. I mean, you have to heal your gut to make sure that it's just functioning to the ability of what goes in comes out in a reasonable amount of time. Right? Because when we eat food and we have feces setting in our gut, setting in our colon, waiting to come out, if it is not coming out because your colon isn't moving it because you're constant, for whatever reason, that is toxin that needs to come out. And if it sets long enough and you have leaky gut, those toxins, guess what? They leak through those holes. And now those toxins are floating around in your bloodstream, and your body's like, what is all of this? And so then it's been making your cortisol go up, it's making your insulin go up, and then that's decreasing your body's ability to convert your thyroid hormone and make sex hormones. And so if you are somebody who struggles with gut symptoms until you fix your gut, I promise you, you're not going to get better. There is no potion, there is no lotion, There is no hormone that's going to help because again, your gut is what's detoxifying all the bad stuff that we breathe, that we eat. And so you have to just get that process at least going. Right? I mean, it's kind of like, this is really gross. But, you know, if you have a porta potty that's full, you don't just keep going into the porta potty and going to the bathroom. Right. Like, I mean, obviously that's same thing with your gut. Like, these people who say, I don't poop for three days or seven days, or, like, do you have any idea the cytokine release and the bad things that are floating around in your body that are just pure toxins wreaking havoc because you haven't gotten rid of the toxins in your body? So. So to answer your question, yes. If there are things in the book that teach you, like, hey, what do we do? What steps do we take to start fixing our gut? And if you do fix your gut and things are leaving your gut naturally, like they're supposed to get that balance back, the good bacteria there, extracting nutrients, helping us digest our food, lowering our insulin, making sure, again, we're converting T4 to T3, we're converting our estrogen correctly. When all these things start to work together, it's magical. And you will feel better. Now, will you feel perfect? That depends, right? I mean, there's so many things that go into that. But I will tell you that even if you're taking thyroid medicine and you're taking hormone medication, maybe you're taking microdose GLP1s, because I like those in moderation until you get your gut functioning correctly and get those bacteria that are supposed to be there doing what they're doing, and get yourself going to the bathroom every day, you're never going to feel better. Doesn't matter how much hormone we give you.
- [48:24]
C
Yeah. Amen. I love that. I love that. Okay, so I said I was going to leave this to the end. You had mentioned earlier that there are actually some free things that we can do that are really impactful to our gut, to our health. So can you. Let's give them two. Let's give them two things for free that they can do.
- [48:42]
A
Yeah. I think one of them is fiber. You know, most people don't focus on fiber, and some people, it bothers them. Right. So fiber. If you're having no fiber and then you throw 35 grams of fiber into your diet, it's not gonna go well. But I teach you in the book about why fiber is Important, like what is it and why is it important? It's important because it feeds our good bacteria. The bacteria that help you digest and metabolize your estrogen. The bacteria that help you digest micronutrients, the bacteria, you know. And so fiber, I think is something that just a lot of people miss. And so there's a whole section on what is fiber, how do I get it? And here are some of my favorite sources. So that's one thing that's pretty easy, right? Fiber, I think the other thing that is super impactful that people just don't think about is to look at the food, but also the liquids that you're consuming because so many of them are full of so much sugar, artificial sugar. So I put a list in the book. Hey, these are actually all sugars. They don't say sugar, but this is all crap sugar that is in every energy drink, every coffee drink, every ollie pop. You know, all these things that people drink that's like, hey, just so you know, this is also damaging your gut microbiome. So just removing those things are so impactful.
- [49:55]
C
That's so good. And that's so easy. It's so easy to do. It's free. It saves you and it's free. Exactly. And it's free. Okay, last, last question. I always like to ask this, you know, we like to disrupt. And I know that you do too. So it's going to be a perfect, perfect question. So what have you found in the health and wellness space that just pisses you off? You just want to disrupt the whole message of what people are putting out there? What is that one thing that really gets under your skin?
- [50:26]
A
I mean, there are so many. Dr. Amy But I would say one of them is, you know, when you're sick and you're not feeling well and you see these people that say, just exercise, exercise more and eat less, exercise more and eat less will fix every health issue you have. I just want to like scream and say slap and throat punch those people. Because I'm like, obviously you know nothing about hormone dysregulation, right? Because when your hormones are really dysregulated, when you have severe hypothyroidism, just like you, you know, in your journey when you started gaining weight and you became hypothyroid and it just like snowballs. It's because when you are exercising harder and eating less, you were messing your adrenals up even further. That stress just. And it, you, it will not work. Like when you're hormones are not working appropriately, when Your gut is dysregulated when your T3 is not where it needs to be and it can't get into the cell. And your cortisol is already high and your insulin's high. Eating less and exercising more makes all that worse. Your insulin is going to get higher, your cortisol is going to get higher, your T3 conversion is going to get worse. None of that actually makes it better. And so people that tell you that are idiots. They don't understand physiology and it will never work. That's all.
- [51:33]
B
Amen.
- [51:33]
C
Amen.
- [51:34]
A
I love it.
- [51:35]
C
I'm with you on that. It pisses me off too. Okay, so now is the time where you need to tell people where can they buy the book and where can they find more to follow you and even listen to your podcast? Because it's amazing.
- [51:48]
A
Yeah. So I'm on Instagram @modernindocrine underscore. My podcast is hormones, metabolism, and you, you can find it anywhere. You get podcast, you know, YouTube, wherever. And then the book is on Amazon. So I just have it on Amazon. You should type in fix your gut, fix your hormones, or my name, Dr. Cassie Smith, and it should come up. That's where you get the book. I have a website, modern-endocrine.com because we do have a physical location in Oklahoma City, but we also provide telehealth to 46 states. So you can go on our website, check out what we offer, what we do. But we, you know, we love working with people, helping them feel better.
- [52:24]
C
Amazing. So we will put all of those links to in the show notes, make it real easy, just click down below. That way you can go right to the Amazon link. We'll have that right there for you. Make it super easy to buy the book.
- [52:36]
A
Yeah. And honestly, you know, I appreciate you having me on and let me talk about this. And I tell people like, you know, this writing a book is not fun. It was like, I don't even know why I did it some days. I mean, it is, it is a chore. But I felt like I really wanted to leave a legacy to the world if somebody wanted to read it, where they could learn everything that I've literally learned in the last, last 10 plus years of, you know, functional medicine. But also, this is the book that when I was so damn sick, I wish somebody could have handed me, I would have paid them $10,000 for this book. Right. I mean, it's just like a conglomerate of information that I was like, wow, it took so long and it took so much of my life and so much of my health and just so much of my time that you never going to get back. Like, this is that book. And whether you do anything with it or not, at least you're educated. Because I, I just hated how people made me feel and made me feel like I was crazy and I was. This book will help you realize, hey, you're not crazy. Here are some simple things you can start doing and then find somebody who believes these things. Right. And it's all in one place and it's all, I mean, you can take as much or as little of it as you want, but it's the book that I really wish I would have had, you know, 15 years ago.
- [53:42]
C
I know, I know. It's so true. And now we have people like us getting the information out, empowering people to take charge of their own health. So that, that's really what it's about, is just infusing that power into the reader. So I thank you for doing that.
- [53:57]
A
Yeah. And I'm so, you know, I'm happy that you wrote the book too, because it's just, it's so empowering and knowledge is so important. And, you know, I tell people, when you don't know better, then that's one thing. But once you know better, I mean, then, then you do better. Right.
- [54:12]
C
And so you can unsee it.
- [54:13]
A
Exactly.
- [54:14]
C
Exactly. Thank you so much for coming on the show. I absolutely love you. If you're listening to this share this episode because we all have gut issues. We all have leaky gut. So every single person needs to hear this message and get this book to fix your gut and fix your hormones and then ultimately, you know, fix your life and fix your thyroid, fix your gut, fix your hormones, fix your thyroid, and then you're gonna fix your life. So once again, thank you so much for listening.
- [54:46]
B
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 healthcare regimen, including medications, supplements or other therapies. Use of the information provided in this podcast does not establish a doctor, patient or client, provide a relationship between you and the host or between you and any other health care 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 hosts or guests and do not necessarily reflect the views of any sponsors. The inclusion of a product, product, or service does not imply endorsement by any healthcare professional featured on this podcast.