Your "Normal" Thyroid Labs Are Lying To You

[00:00:00]Dr. Amy Horniman, welcome to Hello Hormones. Girl, I'm so excited to talk to you again.

[00:00:05]>> I know. Thank you, Dr. Carrie. Thank you so much for having me on.

[00:00:08]>> Well, today we're gonna completely switch topics from before. We're talking all about the thyroid, and this is huge.

[00:00:14]One, because you have a brand new book coming out, The Thyroid Fix, which I'm so psyched for. And two, because the thyroid, I think, is one of the most misunderstood glands. I mean, we talk about estrogen and progesterone, but when it comes to the thyroid, I feel like clinicians and people, women, they just spin in circles like, "How do I know what nutrients help it? What's the right test? What about this medication?

[00:00:34]Is it fixable?" Which is great because the name of your title is the thyroid fix. So, that's what we're going to get into today.

[00:00:41]>> Yes. Yes. And and you know, the thyroid being the master gland, I'm with you. I think it it it deserves a little bit more love. I mean, here's the thing.

[00:00:49]Thank God finally we are at a place where a beautiful light is being shined down upon parmenopause and menopausal women >> right and we're finally being seen for what we're going through but then I feel like like the thyroid's over here going hey wait what about me cuz I kind of control that stuff down there like your hormones and whatnot and your mood and your sleep and yeah don't forget about me so I'm I'm happy that we are now >> shining a light on the master gland as well. And how many times when we talk about hormonal stuff where we say women will go, well, what's the cause of that?

[00:01:28]And I'm like, well, have you checked your thyroid? It's usually the first thing we say or how many times have you said I said even >> it not everything is permenopause. And then women will go, well, what could it be? I'm like, have you checked your thyroid?

[00:01:40]>> Like like fully complex checked your thyroid? We'll talk about testing of course because I think there's such a misunderstanding around just the main test everyone does TSH thyroid stimulating hormone is and some insurance companies won't even test beyond that like it's it's like a no way which gh >> missing the picture but what we're going to do first I'm going to throw out some like things that women in their 40s kind of believe 40s and 50 or been told about the thyroid and I want you to tell me if it's a thyroid myth >> or it's like a total fact like yes that's true.

[00:02:10]>> Okay. So the first one, your thyroid labs are normal. So your thyroid isn't the problem.

[00:02:15]>> So normal is a setting on the dryer. So it should it should never be used to describe your labs first of all. So unless you're hearing, oh girl, your thyroid labs are optimal. They are like shining bright.

[00:02:29]Oh, and by the way, how do you feel? So we always have to overlay whatever your labs are. You know, ultimately we want your labs to be in the optimal range, not just the normal range. The normal range is the standard lab value range.

[00:02:43]Optimal is where we put a bullseye. We scrunch it down. We say, "Okay, now hit this mark. This is probably where you're going to feel your best." But then we also have to go, "How do you feel?" And if your labs look pretty, even if they look optimal from a functional medicine standpoint, and you're over here going, "Well, I still, you know, I'm gaining weight. I can't lose weight no matter what I do. My hair is falling out. I got brain fog. I got anxiety and depression." And then then something's still off. Then we need to to keep going. and maybe find where your optimal is.

[00:03:12]>> That's literally my next question because I think I get this a lot in the comments in the DMs. Women go, "I have hair loss and weight gain and I'm told has nothing to do with your thyroid.

[00:03:22]It's just aging or it's just per menopause."

[00:03:26]>> Gosh, I want to stab myself in the eye.

[00:03:27]These poor women, right? H And you know, here's the shame, Carrie. What if the women believe it? What if they do believe it?

[00:03:36]>> Yeah. And then they stop and they stop pursuing an answer and they stop caring for themselves. H no. Okay. So your symptoms, any symptom that you have is a gift given to you by your body to say, "Hey, Susie Q, you got to look a little bit deeper inside yourself. Look at your hormones. Look at your thyroid. Let's really dig. Let's really test and dig because something is causing this symptom." Your body was not made to just, you know, break down. It's not like, "Oh, well, you know what? I'm 40, so it's time to throw in the towel and just feel like garbage for the rest of my life. Like, no, that's there's not a women's handbook that says that anywhere. So, if you have symptoms, that is a sign that you need to look deeper because you don't have to deal with those symptoms. You never ever ever have to accept that you're just getting older and this is how life is going to be.

[00:04:30]Yep. Here, here, here's one about medication that I get. If you're already on thyroid medication, per menopause won't make it stop working.

[00:04:40]>> Wait, if you're already on medication, >> if you're already on medication, per menopause won't make it stop working. Or let's say even like per menopause won't affect your like won't make you need to adjust the dose.

[00:04:51]>> Oh, I've had endocrinologists literally say to the patient who's related to me, they've said, "I'm on medication, so like I'm fine." like it doesn't matter that I'm going through this whole permenopausal transition. It has nothing to do with my thyroid medication. And I'm like, >> ah, gotcha. Gotcha. Okay, great.

[00:05:11]>> Well, so first of all, chances are that anyone listening to this, unfortunately, you are on T4 only if you have been diagnosed with a thyroid problem. And just like Harry talks about all the time on the show, you know, T4 only, it's not going to cut it. It's just not going to cut it. And that's why we will use bring in T3, we'll use natural desecated thyroid, we'll use compounded T4 and T3, right? We'll bring in that active thyroid hormone because we know T4 only just isn't going to cut it. But it gets even deeper when you go into pmenopause because when your progesterone level drops, progesterone is a beautiful hormone that helps convert that inactive T4. So T4 is totally inactive. You have zero receptor sites in your body for T4 thyroid hormone. It has to become T3 in order to attach to that receptor site to turn on your metabolism or turn on your brain. So progesterone comes along and actually helps a little bit with that conversion. Now there are other things that come along and help as well. But we see many many women all of a sudden who have been on thyroid medication for the last 15 years. That medication is no longer working. symptoms increase like crazy. Yes. It's hormonal decline and your thyroid is being affected because you are in that hormonal decline. Yeah.

[00:06:27]Oh my gosh. And I feel like we see this all the time. And I routinely say just I'm like free T3 makes the world go round. It's it it's the start button for so many things in the body and yet frustratingly they just stop at T4 and hope for the best. I'm like what?

[00:06:45]>> What? No.

[00:06:46]>> Okay. What is the biggest red flag that you see that a woman's thyroid is being undertreated >> when she has those symptoms? So, it's it the big ones the big big big symptoms are the weight gain that just comes on no matter what you're doing, how clean you're eating, how much you're working out, how much you're biohacking, or you're actively trying to put on those 20 pounds that just came on over the last 6 months and nothing is working.

[00:07:13]you're fasting, you're carnivore, you're doing all the things and nothing is working. So, that's symptom number one.

[00:07:19]That's a big one. Number two is that fatigue and it's a crushing fatigue.

[00:07:23]It's like your eyes are getting really super heavy at 2 p.m. You're praying to God if you could just lay down for like 10 15 minutes just. It's that crushing fatigue that Red Bull's not going to help. Caffeine's not going to help it.

[00:07:36]And then there's I would say number three, it's it's a close tie. There's the hair loss. And you've probably seen it, the women that literally like gather the hair from the sh and put it in bags so someone will believe them and this is how much hair I lost yesterday, you know. So it's the hair loss, but it's a close tie with anxiety and depression.

[00:07:56]And with anxiety and depression, these poor women will get the anti-depressant band-aid.

[00:08:00]>> So many of you are on an anti-depressant right now. I would say probably 80% of you don't actually need it. You need to address your thyroid and your hormones.

[00:08:10]Now 20% legit. Okay, you know, brain chemistry imbalance, all that. Yes, there are some people that need it. I'm not going to discount that, but a lot of us are given that band-aid medication for anxiety and depression when we don't need it.

[00:08:23]>> What do you think is one thing that women do routinely that's tanking their thyroid? Like, what do you see in social media that gets talked about a lot or show up in your comments and you're like, that action right there is ruining the thyroid axis?

[00:08:36]>> It'd be like overex exercising, undereing, too much fasting. It's it's the extreme. It's the desperation. You know, back in the day, what was this probably like about 10 12 years ago where CrossFit was all the rage.

[00:08:48][laughter] >> Yeah.

[00:08:50]>> People were killing themselves seven days a week at the gym. That is over exercising. I mean, you don't have to go to the gym for three hours or go twice a day to be an overex exerciser. You just have to crush your body on the regular and and that is a stressor on the body that increases cortisol that that tanks your thyroid. So that undereating like overrestricting like maybe if I bring my calories to 900 a day, you know, and and the GLPS gosh, they're such jackal and hide. They're fantastic when you use the correct way, but they're crushing people's appetite and now you're undereating. You're not taking in enough calories and you're losing muscle and that's affecting the thyroid as well.

[00:09:30]>> Yeah. I would I also see Tell me if you see this as well. I see what what we call orthorexia. So not eating or not eating a lot or being really restrictive in what you eat in the name of health.

[00:09:42]So when I do cortisol testing with the Dutch test in particular when there's one marker metabolize cortisol when it's quite low it can be to anorexia but we also see it with this orthorexia because the the thyroid drops T3 drops and therefore you don't metabolize including the metabolism of cortisol. So, it's this cool little backhanded indicator to us of like, hey, looks like you have a thyroid problem deep in the cells. One of the reasons could be this extreme restriction in the name of health. Now, it could be full-blown anorexia, don't get me wrong, but I agree with you. I think in the the day and age of biohacking and and still with the boot camps and the the classes and the courses and the all this stuff that people are extreme into, then they're like, "Well, now I'm going too fast. Now I'm going to restrict. I'm going to cut all these things out." in the name of health not realizing what it's doing.

[00:10:36]>> Yes. Yes. 100%. It's it's it's just that over it's the overdoing and even biohacking, right? We have all these different biohacking tools now. And I get questions all the time. Well, should I buy a red light? Should I buy a sauna?

[00:10:49]Should I buy that? All of those biohacking pieces are are a great add-on, but they're not going to solve the root problem. You're not going to red light your way to more T3. You're not going to sauna your way to optimal hormones when you're in pmenopol. You know, it's it's like they're just they're just there as a helper. But I think too too often people dive into it and think, well, that's the answer.

[00:11:18]That's the be all end all. and and they end up putting more even supplements, more things in their body on their body than just like how about you just get the hormone that you need that your body is no longer producing properly. That's that's like one pill, two pills as opposed to five different biohacking things and 20 different supplements.

[00:11:38]>> Yeah, most definitely. Well, you talk in your book about thyropause and I think that's the coolest name ever. Being a science nerd, I was like, "Thy why didn't I think of that?" which of course is where thyroid dysfunction and pmenopause collides. So I want you to start there like how did what do you what do you see when you see women go into pmenopause and their thyroid's a mess or their thyroid is already a mess and then all of a sudden yeah >> you know they're right there in pmenopause getting even worse.

[00:12:08]>> Getting worse. Exactly. So thyropause the definition is when your thyroid gland craps the bed after the age of 40 due to fluctuating hormones. Why do we say that? So, let's look at thyroid conditions. Overall, hypothyroidism or low and slow thyroid function. 95% of all hypothyroidism is Hashimoto's. It's the autoimmune form. So, it's where we have these little auto antibodies. I call them soldiers. And these soldiers in your body, they're totally confused.

[00:12:36]They think that your thyroid gland is a bad guy. They just got programmed incorrectly. So, they often go out and they like to start a war and beat up your thyroid gland. Okay, so we have that. Now, what actually triggers autoimmunity? And way back in the day, I love giving props to Allesio Fisano. He used the the whole analogy of a three-legged stool when we're talking about about autoimmune. And on the one leg, you have the genetic predisposition. So, your mom, your grandma, your aunt had maybe Hashimoto's, maybe they just had another autoimmune condition, type 1 diabetes, lupus, MS, Crohn's, whatever, celiac.

[00:13:12]Then we have a a leaky gut as the second leg of the stool, which uh pretty much we all have. I'm pretty sure we all have leaky gut at this point with the amount of toxins and chemicals that we're constantly being bombarded and exposed to. And then we have a stressor. That stressor is often puberty, pregnancy, pmenopause, menopause because think about it, those are the times in a woman's life. And yes, Hashimoto's and thyroid conditions hit women a million times harder than men. So right now the stats are one in eight women, but remember those are diagnosed.

[00:13:47]>> Yeah.

[00:13:48]>> So what are they really? Probably about one in four, one in two. Yeah.

[00:13:50]>> Get hit with a thyroid problem. So those times in a woman's life where your hormones are on a roller coaster.

[00:13:57]Listen, I get it that pregnancy is a beautiful natural thing, but come on ladies, your body is freaking out and your hormones are going crazy and it's it's usually, you know, it's like, oh, you know, it was after my second kid that my body went to hell in a hand basket. Like it's like everything just came on after that, right? Because that hormonal chaos and parmenopause is no different. Menopause is no different.

[00:14:21]That hormonal chaos is enough to flip that Hashimoto switch that was just sitting in the off position for years, decades. Boom. Turns on.

[00:14:32]>> So now you have the symptoms of the declining hormones that you talk about.

[00:14:36]Now you have another layer. Now your master gland is also tanking. So now you have even a lower metabolism. You have more brain fog and more anxiety. And it just compounds upon the already declining hormones of parameopause.

[00:14:54]And I said this before earlier because everything gets blamed on parmenopause directly and nobody it feels is taking the lens wider to go and what else is this affecting >> like the thyroid for example. So everyone's like oh that brain fog it's because you're 45 and your estrogen is dropped. Oh, that anxiety. It's because you're 50 and you have no progesterone.

[00:15:18]And And so estrogen, progesterone are getting the brunt. Even libido. Oh, it's because you don't have any testosterone.

[00:15:23]Thyroid plays a big role in libido.

[00:15:25]>> Yep.

[00:15:26]>> And nobody is doing the full workup >> on a thyroid. Not really, right? No, you're 100% You're 100% correct. In fact, I I I think that like [snorts] your book and my book should be packaged. I know.

[00:15:39]>> Like [laughter] you you must read both of them together.

[00:15:43]You know, >> exactly >> because they go together. They marry up.

[00:15:46]Like you can't look at one without the other.

[00:15:49]>> Okay. So, when somebody goes to the doctor, we already know what's going to happen. They're going to go, they're going to report symptoms and their doctor is going to run one test. So, let's talk about thyroid testing, like what's traditionally done and why versus what Dr. Amy suggests.

[00:16:05]>> Yeah, this is so unfortunate. So, unfortunately, docs are taught one thing. Medical school is you test TSH thyroid stimulating hormone which side note that is a brain hormone it's not a thyroid hormone so but it's in standard of care it's what we test so test TSH [snorts] if TSH is above right now the cutoff is a 4.5 this has been debated through the decades it used to go all the way up to a 10 it's important to note that TSH is one of the only markers where high means low so the higher that TSH number goes the lower and slower lower your thyroid is functioning. So we cut it off right now at a 4.5 where above a 4.5 a conventional medicine doctor will say okay there might be hypothyroidism here. So test TSH. If TSH is above a 4.5 you give T4, give levo, give Synthroidid, send a patient on their way, pat them on the back, wish them luck, tell them you'll test them in six months. Now the problem with that, it starts at the beginning.

[00:17:06]TSH is a brain hormone. weight. Why aren't we looking at the thyroid hormones? Number two, the standard lab value range taken from groups of sick people, functional medicine comes in and goes, you know, we really like that TSH to be below a two.

[00:17:20]>> Yeah.

[00:17:20]>> Because when it's above a two, you know, we're starting to see these thyroid symptoms. And then when we look deeper at the other labs, we see dysfunction there. We see low free T3, that active thyroid hormone. We see elevator reverse T3, your antiyroid hormone that puts your body in survival mode. So h yeah yeah let's not just go by that standard lab value range then we jump to the next portion of traditional standard care and that's to give T4 only. Wait, why are we giving the active or the inactive thyroid hormone and then we're crossing our fingers and wishing on a rainbow that this person converts that over to T3. Well, guess what? That T4 to T3 conversion is a hard hard job for your body to do. I equate it to running 10 tough mutters in a row. Estrogen dominance, insulin resistance, low vitamin D, low iodine, low selenium, high cortisol, genetic snips. I mean, all of these things can get in the way of that T4 to T3 conversion. And we just we just explain, I'll just take this.

[00:18:21]You'll be fine. Okay. I live in a toxic soup world and I'm stressed all the time and I'm going to be fine.

[00:18:26]>> Yeah.

[00:18:26]>> Like, I'm not going to conver. And some people like myself don't convert at all.

[00:18:32]So, I am a nonconverter. I do. You give me T4 and I will go hypothyroid in a week. I've actually tried it on myself.

[00:18:40]I gained seven pounds and became clinically depressed in seven days when you give me T4. So I just don't convert or I push my T4 to the antiyroid hormone T3 reverse T3.

[00:18:53]>> And I think this is probably not pro not even think. I mean let's just be real like this is really common.

[00:19:00]It because it's standard of care.

[00:19:02]>> Yeah. The TSH range is a range but not optimal. Women don't feel optimal.

[00:19:07]They're put on a medication that may not optimally convert into thing the thing you need which is T3.

[00:19:14]>> And I think it's wild to me even just from a genetic standpoint. I was looking at a genetic snip yesterday that uh PTE and it was all about conversion or even the DIIO snip which again has to do with conversion. Like nobody needs to like everyone listening doesn't need to know this but and it was talking about like yeah if you have this you're not going to convert very well so you're just going to get blown off pushed off a oh you just need a higher dose I don't know what's wrong with you good luck this is all we have and then you still feel like crap yeah I know it's unfortunate it it really is but that is that standard of care in our country that is unfortunately how the major Majority of women are treated when they go to see their doctor.

[00:20:01]>> Can you talk about you said estrogen dominance, high cortisol, of course, insulin resistance. Can you touch on how that plays a role in what the thyroid chooses to do or not do?

[00:20:11]>> Yeah, absolutely. So, estrogen dominance and I mean, and you know this, a lot of women will say, "I'm estrogen dominant."

[00:20:16]They're really not. You know, they like to kind of, but then some of them are, right? And we can be estrogen dominant as our progesterone drops. So, it's not that you just have too much estrogen or too ha have too high of a level of estradiol. It's that you have too little progesterone and that balances off. So with that estrogen will increase thyrobinding globbulin or TBG and that thyroid binding globbulin will bind to the free hormones of the thyroid free T3, your active thyroid hormone and it will basically prevent that T3 from getting to the cell to do its job. Just like sex hormone binding globbulin will bind to our sex hormones, thyroid binding globulin will bind to our thyroid hormones and elevated estrogen will will increase that. So that can be an issue. uh insulin resistance, high cortisol, just producing that level of inflammation in the body where our bodies know that, hey, when we're dealing with this extreme stress, when we're dealing with inflammation, when we're dealing with a body that is that is just off, it's it's inflamed. I mean, insulin, high insulin is inflammatory.

[00:21:29]High cortisol is an inflammatory state.

[00:21:32]So when we're dealing with the body in that state or in a nutrient deficient state, what our bodies know to do, and this is actually built into us, thank God, as a survival mechanism, what our bodies know to do is in that time of crisis, in that time of high stress, in that time of injury, illness, sickness, we're going to shut down the metabolism.

[00:21:55]What we're going to do is we're going to increase something called reverse T3.

[00:22:00]and reverse T3 rises in order to tell the body at this moment in time, this woman does not need to lose weight, does not need to make major decisions, does not need to grow her hair, does not need to even feel good or poop every day. She needs to lie there and calm down that inflammation and survive and heal. But the problem is that's fantastic. If we've we're in an accident, like we're lying in the ICU, the ER, amazing. I I I I want my body to shuttle its forces to healing and survival in that moment. But if we're walking around trying to live life, >> Yeah.

[00:22:34]>> and we're trying to take the kids to school and we're trying to cook dinner, we're trying to run a business and we're trying to be the best, you know, like women do, the best mom, sister, you know, spouse, friend, entrepreneur, business, the best of everything all at the same time. And our reverse E3 is elevated and our body thinks that we're lying in the ICU dying. That's a problem. Yeah.

[00:22:56]>> So, I know that was a really super long answer to a short question, but it all kind of tied together and it's just it's just true. So, yes, elevated estrogen, cortisol, all of that will interfere with that T4 to T3 conversion. Well, I think it's a really important point to routinely hit home because oftentimes women are like, just give me more or I'm on T4, just give me T3. and then don't realize stress and lifestyle, glucose, insulin, estrogen, you know, etc., etc., etc., etc. Yeah.

[00:23:29]>> Is playing a large, if not overriding role. And so they're like, I'm still losing hair. I must need more hormone.

[00:23:36]Like, actually, your body is completely stressed out. And it totally thinks it's in a fight orflight situation, laying in the ICU. It's diverting resources. Just like Dr. Amy said, I have women that are like, I'm losing so much hair. Why? I'm like, because hair is important to you and to me, >> but when you're in a stressed out situation, hair is not a survival tactic. That's not your heart or your brain or your lungs. Those are way more important than growing hair.

[00:24:04]>> But just as you said, like our stress is just everyday life. It's it's partners, it's kids, it's work, it's the news, it's >> it's everything on top of each other.

[00:24:14]And I think this is a really common story. I think a lot of women are listening going, "This is me." Like, this this is this is me to a tea. This is the story that I could tell. I feel like you're talking about me in this whole conversation. So, for that woman who's listening, raising her hand, nodding along.

[00:24:33]>> Where should she start? Obviously, read your book first and foremost. Read your book. But secondly, what's the first thing she should do?

[00:24:41]Because, you know, she's just had a TSH run. you know, she's been told it's fine, it's in range, or she's just on T4. What did she do?

[00:24:50]>> Okay. Okay. For her, I want you to first bullet list your symptoms. So, you know, don't write out your life story. No paragraphs, nothing. Just I want you to bullet list every symptom that you can possibly think of. Even if you're like, "Ah, that's not thyroid related." I don't care. Write it down. Joint pain, shoulder pain, frozen shoulder, boom, write it down. Your big toe hurts, write it down. [snorts] And then we have to get further testing. So we already talked about it. The importance of knowing your numbers and layering that over your symptoms is key. Now you are more than a lab value. That's why I want you to write your symptoms down first.

[00:25:27]But then we have to get that free T3 reverse T3 and let let's get some antibodies too. Let's let's at least get that full picture. Now, if you go to your doctor and you say, "Hey, doc, these are just just a couple more labs.

[00:25:42]Can you add these on to my lab order? I just I just really want to see, you know, that full picture of my thyroid."

[00:25:47]If your doctor says no to labs, it's time to get a new doctor because it guess what? It's no money out of their pocket to write you additional lab orders. Like, it it doesn't it doesn't take any money out of them to write reverse T3 on there. Now, they might say to you, "Well, you know, your insurance might not cover it, but guess what? That is your decision. that is your decision if you want to roll the dice with your insurance or pay out of pocket to get the information. There's also many order your own labs out now that any lab test now um labs there's so many you can order from Yeah, right. Right. Directly is a patient ordering their own. Yep.

[00:26:27]>> Exactly. So, we have that power now >> to get that information. And then this is where I would actually direct her to the book because here's the difference in the thyroid fix from any other thyroid book out there. I I I joke and I say it it's not a diet book. It's not a workout book. There's no recipes in there. And it's not a sprinkle fairy dust and heal your thyroid naturally book. It is raw and is real as truthful.

[00:26:52]But it is going to make the buttholes of many a Dr. [laughter] because I'm actually I'm actually teaching you how to decipher your own labs. So when you look at your symptoms and you look at those labs and then over here you're like I am on synthroidid at 88 micrograms. It's like a choose your own adventure book how I laid it out. So it's okay if this and this and this then this >> this is what I need to change. If this this and this then this is what I need to change. Now you have the information to go back to your doctor and and have an educated, honest adult to adult conversation, which they should respect you for having if they have a god complex or you feel like you are being demeaned because you are bringing your information that you learn and took the time to learn to them and it's about your body, then that's another red flag to leave. So there's little markers along the way to where you know, should I stay or should I go? Should I stay or should I go? Should I give this person a chance or not? Now, if you make it all the way to the end and you're having that educated conversation of, you know what, I think um I think this T4 has put my body in survival mode, you can see my reverse is high. I think we need to lower this and if we can add in some T3 and here's how I would like to do it.

[00:28:08]Maybe NDT, maybe compounded, whatever.

[00:28:12]And then at that point of time, you get shut down. I also have ways to find the new doctor. So actually like points to ask even when you're calling to make the appointment when you're talking to the to the front desk staff that's scheduling you and god forbid before you hand over money to functional or integrative or cash pay businesses you need to be asking these questions and these are key questions that I have even heard and learned from my patients coming over from different practices through the years just like we talked about earlier a T3 cap do you have a limit on the amount of T3 that that you would prescribe to people, you know, do your doctors believe that a that a a suppressed TSH below a one is going to cause osteoporosis and aphib. You know, just little little kind of questions that you can ask so that you know whether this is going to be a waste of your time or not.

[00:29:06]>> I think that's so helpful. And I also want to put out there, notice Amy didn't say it has to be an endocrinologist because like her clinic manages thyroid in but I was in full practice for years.

[00:29:18]I manage thyroid. I'm not an endocrinologist.

[00:29:21]Yes, an endocrinologist. They can manage thyroid but do know like you can ask a number. So if you see you're OB, you have a primary care, you do have somebody you see who's on the more functional integrative spectrum, you know, there are a lot of you see a wonderful nurse practitioner, a physician's assistant, like start asking everybody because unless they just full stop don't manage thyroid, which can happen. A lot of practitioners do manage thyroid, they don't refer to an endocrinologist, they they happily take it on.

[00:29:53]>> Absolutely. I actually had this this running tally through the years of anytime I would run into a patient that had or a person, so they weren't even a patient. They were just, you know, a member of my community person, listener, follower, they had a good endocrinologist, they're like, "Yes, when endocrinologist, they prescribe T3 and they listen to me." And I I took every country. Like I even had some in Australia over the course of I want to say it was nine different countries over three years. I had a total of three good endocrinologists. Oh, >> that's every state in the United States and multiple. I mean, Canada, South America, the EU, we had Australia in there. Three good endocrinologists. It's unfortunate they I mean the reality is they're really pretty much stay in their lane with diabetes.

[00:30:43]>> Yeah. Which is that's great. Yeah.

[00:30:45]>> Yeah. Yeah.

[00:30:46]>> But for some reason, >> right, man, they just Yeah.

[00:30:49]>> can't handle it. The other thing I just want as we sort of wrap up is to remind women who are listening. Yes, I absolutely brought up pmenopause because that's what I love to talk about Amy talks about too, but this could happen at any age, right? Like somebody listening could be thinking of their 20-year-old daughter going, "Wait a minute, that's her, even their teenage daughter." Or somebody could be listening who's 35 and thinking, "Well, I'm not permenopausal, but I have all those symptoms and I've been really suspect if I have a thyroid problem or they could have a thyroid problem." I think the youngest thyroid patient I ever had. I by the time I saw her, she was 14, but she'd been diagnosed with Hashimoto's at seven because mom and all aunts had Hashimoto. So her pediatrician was like, "hm, let's just start testing." And sure enough, at 7 years old on her very first test, she popped for Hashimoto's. So do know it's not just something that could develop later in life. It could be at any of these ages.

[00:31:44]>> Oh, for sure. I'm so glad you mentioned that because I was early 20s.

[00:31:47]>> You were early.

[00:31:47]>> I was early 20s when it hit me too. So you you are absolutely correct and that's why we said you know puberty.

[00:31:54]>> Yeah.

[00:31:54]>> Perry men pregnancy parmenopause menopause. So it can happen as early as puberty or any anything that's going to turn on that switch. So for me I had the genetic predisposition. I had psoriasis which is another autoimmune condition.

[00:32:09]So there was like a little hint of autoimmunity there. And then I competed.

[00:32:14]I overex exercised and underate in a competition setting. So it's like, okay, this isn't an eating disorder setting or a body dysmorphia setting. This is competition. Well, no, it's it's an eating disorder, body dysmorphia setting, too, when you when you compete in bodybuilding and figure and and that extreme extreme stress on the body, just turn that switch on. So it can happen anytime.

[00:32:38]>> At any time. Oh my gosh, Amy, this has been amazing. Tell everyone about the book. We I want we need all the details when it when it's out, where they can get it, the landing page where they can find out more, everything.

[00:32:50]>> All the things. Absolutely. So, depending on when this is released on May 12th, the Thyroid Fix book will officially be out. But anytime before that, you can pre-order and go to thyroidfixbook.com.

[00:33:04]And on there, it'll connect you to Amazon and all the major retailers to pre-order to order. But then you'll also see all the different bonuses. So you'll get a 20% off code to Fixer Formulas, the supplement store. You get entered to win a year supply of thyroid fixer. You get hidden podcast episodes that were never released before. You get a ticket to our all day live event on May 16th.

[00:33:26]So there's a lot of extra bonuses. Even if you hear this before May 12th, buy it now because then you get into all these bonuses. But honestly, the thyroid fix, I I wrote it to be the thyroid bible, the last thyroid book you will ever need for the rest of your life. It's a toz.

[00:33:44]It it literally walks you through. And and here's the thing I realize, and really it's the culmination of this entire conversation. There are really good medical practitioners out there, but they are so few and far between when it comes to the nuance art of thyroid.

[00:34:00]>> Yeah. So, I know that many people have to go functional and integrative. That costs money. That's out of pocket. I know that not everybody can afford that.

[00:34:10]I wanted this book to be the guide that will get you to that next level of health. Get bring you into what I call optimization land. It's a beautiful place to be. You don't gain weight looking sideways at a brownie and you have abundant energy all day long. So, I want to help. I mean, this is our goal, Carrie. We want to help so many women live their best life where they shouldn't suffer. They don't have to suffer. And that is why I wrote this to literally get into the hands of every single woman out there, especially if you're over the age of 40, so that you can can be prepared or at least jump in right now. I don't care how long you've had a thyroid condition or how long you've felt like garbage. Maybe you don't even know if you have one or not.

[00:34:51]I don't care how long you have felt like garbage and dealt with these symptoms.

[00:34:55]It can be reversed. So, it's a Bible and hope all tied into one.

[00:35:00]>> I love that there's been so much mystery and mystique and just weirdness around thyroid for so many years, just as you said. So, I am so excited for this book to come out. I am so honored to have you on the podcast and to be so funny, first of all, and forthcoming in everything, how you look at it, your optimal labs, what you're looking for, everything around free T3. just just giving women the confidence and the power to be like, "Hold on, I do feel like garbage. I it definitely could be or I do have a thyroid problem and this needs to get addressed deeper." So, thank you so much for coming on today.

[00:35:38]>> You're quite welcome. Thank you so much for having me.