Full Transcript Podcast Introduction and Guest Welcome 0:00 I do some doctor Googling and I find out that this T4, it's inactive. 0:05 It actually, doesn't do anything in our body. 0:07 There's this other thyroid hormone called T3 and oh my God, that's active. 0:11 That's like your gas pedal. 0:13 So I go back to her and like, can we add in some of the gas? 0:16 Like it just makes sense. 0:17 Can we had in the active thyroid hormones? 0:20 You're listening to the Lifestyle Medicine podcast with Dr. 0:23 Ivan Rusilko, brought to you by Access Lab, where we explore new perspectives at the forefront of personalized healthcare. 0:34 All right. 0:34 Welcome back to the lifestyle medicine podcast. 0:36 I'm Dr. 0:36 Ivan Rosilko, your host, and we're powered by Access Medical Labs. 0:39 If your doctor's not checking your labs, they're not a doctor. 0:42 And do we have the thyroid fixed today? 0:44 We have Dr Amy, who has made a career, not only personally, but professionally, in making sure that people's thyroids are at their maximum. 0:52 Dr, Amy I cannot wait to get into your story. 0:54 You got your book, you got to your clinic. 0:56 We're going to talk about all of that right now. 0:58 But first and foremost, can you please tell us about your history as a fitness model and why the thyroid is so important about that? 1:04 Oh, Dr. 1:05 Ivan, thank you so much for having me on. 1:07 You had to know I was going there, by the way, so. 1:09 I knew, I know, because, you know we share a similar love, right? 1:14 We do, we do. 1:16 Just that whole challenge of getting your body in the best shape ever, that's why I did it way back in I wanted to see, and you know, 1:24 listen, I was a fat kid. 1:26 I came from a family with obesity and type 2 diabetes, so I battled at a very young age.
Dr. Amy's Fitness Modeling Background 1:34 My body's propensity to hold weight. 1:37 So when I in my 20s, really got into fitness because I really wanted that challenge of seeing where could I take my body from an athletic standpoint. 1:47 So I got into competing in figure competitions and I was doing fitness modeling. 1:52 Now I, was one of those girls who always had to diet down. 1:55 I needed like the 12 week runway of prep time for a show. 2:00 So, I wasn't walking around skinny and just could step in front of the camera in a bathing suit. 2:08 Oh, I know I hated those people. 2:10 I hate it up. 2:11 We actually had to work a little bit. 2:12 Exactly. 2:13 But you know, we busted our butts at the gym. 2:16 we macro counted, We prepped food on Sunday, the whole deal. 2:21 So I had done plenty of these shows. 2:23 knew what I knew how my body had respond. 2:26 had a coach, checking in with the coach. 2:27 The whole thing. 2:29 Well, this one show I'm getting ready for, it's a national level show. 2:33 And every time I'm getting on the scale to give my coach my weight and my progress picks, the scales going up and the picture is getting bigger. 2:41 And I was like, what's happening right now? 2:45 This is, so you start questioning yourself. 2:47 You're like well, all right. 2:48 Maybe if I go to the gym three times a day, maybe I'll cut like a couple hundred calories out. 2:54 I won't tell them. 2:55 Well, just, I will just remove that sweet potato. 2:58 You start, you start gaslighting yourself. 3:01 You're like, maybe I'm not doing enough. 3:03 Maybe, it's me. 3:04 And maybe, I am going crazy. 3:06 So what I did is what all the listeners do too. 3:09 I went to my doctor and I said what was going on. 3:12 My doctor ran some labs. 3:14 Now I don't know what they were at the time, but we can certainly guess and we'll probably talk about that today. 3:20 They were probably half ass labs, Ransom Labs and said the famous infamous, you're normal. 3:28 You're a normal type situation, right? 3:31 Yes. 3:31 The gaslighting, gas lighting, your normal, everything is fine. 3:36 So, I left and I'm like, don't feel normal and don' feel fine, so I am going to go for a second opinion. 3:41 Okay. 3:42 Well, that second, opinion turned into six, six different doctors. 3:48 Who all told me I was normal? 3:50 Do you know one of them actually told, me to eat less and exercise more? 3:54 Come on. 3:54 I'm like, dude, how is this traditional medicine in a box here? 3:58 I mean, geez, Louise, it's, It wasn't even possible. 4:02 And I know there's listeners out there right now going, I literally doing all the things I've doing. 4:07 All the biohacking. 4:08 Hey, that term too, doing everything and nothing is working. 4:13 Yeah. 4:13 That was the same for me. 4:14 So finally, when I was diagnosed by doctor number seven, Okay. 4:25 Lucky number seven. 4:27 And I was so happy, Dr. 4:28 Ivan, just to get the name, right? 4:30 So she goes, you have hypothyroidism. 4:35 It's actually Hashimoto's, which is the autoimmune form of hypathyroid. 4:40 Here's a pill. 4:42 So, I mean, naturally I did, a happy dance.
Misdiagnosis, Hashimoto's, and Finding the Right Thyroid Treatment 4:46 I partied all the way out to my car. 4:47 That's like, hallelujah. 4:50 And I had a pill, right? 4:52 The pill is going to change my life. 4:55 Well, that pill was T4, it was Synthroid, Levothyroxine. 4:58 Many of your listeners are on that right now and I got news for you. 5:02 It's an inactive thyroid hormone. 5:04 So I'm taking this thing, It is doing nothing. 5:07 it's doing, nothing in my body. 5:10 so I do some doctor Googling. 5:12 And I find out that this T4, it's inactive. 5:16 It actually, doesn't do anything in our body. 5:18 There's this other thyroid hormone called T3. 5:21 And oh my God, that's active. 5:23 That's like your gas pedal. 5:25 So I go back to her and I'm like, can we add in some of the gas? 5:28 Like it just makes sense. 5:29 Can we had in the active thyroid hormones? 5:31 She goes, ready? 5:33 You're going to love this one. 5:35 She says, That not standard of care. 5:37 I don't that. 5:40 Textbook, textbook nonsense. 5:43 My God. 5:44 So doctor number eight, who saved you? 5:47 I have to figure this out now. 5:48 I'm curious. 5:50 That's when I went into integrated medicine, functional medicine. 5:53 We were talking off air back then. 5:55 They didn't use the term functional, right? 5:56 It was integrative. 5:57 It, it was still woo. 5:58 it, was like alternative new age, Right? 6:02 it. 6:02 Was woo, which doctor, but you know what? 6:05 He sat with me for 83 more minutes than any other doctor sat. 6:09 With me. 6:12 And he gave me the answers that I needed. 6:14 and he put me on the right thyroid hormone and I got my life back. 6:19 I love that. 6:19 Now, could you give me a favor and break it down? 6:21 Because there's probably people sitting there looking at their Lebo Thyroxine right now being like, what in the hell am I on? 6:27 Can you kind of explain the difference between the T3, T4 combo pills or the actual T-4 itself? 6:33 Absolutely. 6:35 So like I said earlier, as I was doing my research, and now I very much know this, T4, that is your inactive thyroid hormone. 6:44 First of all, with the thyroid itself, just for the listeners, from head to toe, it runs the show. 6:51 So your thyroid runs your entire body from the hair coming out of your head to the cracked heels and your toenails on your feet. 7:01 It literally runs everything in between brain function, mood, metabolism, gastric motility, immune system, the whole deal. 7:08 But. 7:10 That T4, that inactive thyroid hormone does nothing in your body. 7:16 It has to transform, it has become T3. 7:20 So it as to do something we call conversion. 7:22 And as the convert and become the T-3, the active thyroid hormones in order for it to attach to any cell in you body and to you any job in body, 7:32 so that's the key point right now. 7:35 that listeners need to know is T4 is inactive. 7:38 So that levosynthroid you're taking, it's not doing anything unless it converts. 7:43 Now, one of the things I say in my book is that T-4 to T3 conversion is like running 10 Tough Mudders in a row. 7:49 It's actually very, very hard for your body to do. 7:53 Yep. 7:55 Let's talk about what caused it and what stimulates it now. 7:57 I mean, that's a perfect lead in, I love this. 8:00 So what causes that, well, what hinders that T4 to T3 conversion? 8:06 Let's say that. 8:07 So, What hindered that t4-to-t3-conversion? 8:10 Insulin resistance, estrogen dominance, nutrient depletion, high stress, inflammation. 8:15 The American lifestyle. 8:18 Right. 8:18 Basically, you breathing. 8:20 Exactly. 8:21 Like liver, gut, genetic SNPs. 8:24 I mean, the list goes on and on, and so you look at that list and you go, Well, yeah, now I get it why it's a hard job for the body to do, 8:32 right? 8:32 It's very hard. 8:34 Very hard, very, no, for sure. 8:36 For sure, so, you go through the entire process. 8:39 What was, what would you say, how long did it take for you to feel that T4? 8:43 Now all of a sudden you got some T3 going on. 8:45 Was it immediate? 8:46 Was there a few days? 8:47 was it like a week? 8:49 Can you explain that? 8:50 I'm very curious. 8:51 Gosh, I was so long ago, that the lights started coming on. 8:55 I didn't start losing weight that first month, but when you start actually giving your body what your needs, from a thyroid hormone perspective, 9:04 it's almost like this dark veil lifts and the light has been turned on for the first time. 9:10 So for the first time I had hope, I felt like someone actually understood me. 9:15 He explained my labs, he tested everything that needed to be tested, not the half ass labs.
Understanding T4, T3, and Thyroid Conversion 9:23 Right. 9:25 And it's like, it just, you know, something just lifted for me. 9:28 Now the weight actually started shifting by like month two and three, because my body was actually coming out of the dungeon that it was in for so long 9:39 and it coming up out the hole. 9:41 Then it like now we can have a metabolism and not store everything that this person puts into their mouth. 9:47 For sure, for sure. 9:48 And again, it's a situation I don't think people understand that. 9:50 I mean, just because your thyroid is working and you get labs basically, TSHT-3-T4 are kind of the standard, correct? 9:56 And that's kind, you know, where every doctor tests. 9:58 But I would say that is one-fourth of an actual equation in understanding what your thyroid is. 10:02 So now, when it came to your diagnosis of Hashimoto's, can you explain to the listeners what that means and what was tested to actually diagnose that? 10:10 Yes, so to diagnose Hashimoto's, we test TPO or thyroid peroxidase antibodies and thyroglobulin or TGA or sometimes you'll see anti-TG on your lab. 10:24 Those are both antibodies that test for the autoimmune condition Hashimoto's. 10:29 So let's break this down. 10:31 When we talk about hypothyroidism, low and slow, so think hypo, slow and low. 10:36 Low thyroid function, hypathyroid, 95% of all cases are actually autoimmune caused. 10:44 Only about 5%. It really is a lot. 10:47 I mean, autoimmunity dominates when we're talking about thyroid issues. 10:50 5% will be from chemotherapy, radiation, sometimes eating disorders. 10:57 I mean, we saw a lot of hypothyroidism from just competing from people over exercising and under eating, they caused it themselves. 11:05 Or like I always say, bodybuilders were the OGs of biohacking. 11:09 They would start experimenting. 11:12 Right? 11:12 We would start experimenting with some T3 to lose body fat for the show. 11:17 And then they come out. 11:19 Now they got a thyroid problem. 11:20 Right now. 11:20 That's why they're 40 pounds heavier. 11:22 We know most of it is autoimmune. 11:25 So you have, I love using analogies for people to understand. 11:28 You have these little soldiers. 11:30 And those are your antibodies. 11:31 So let's say you test TPO and you see 100. 100 soldiers are going out and they're programmed incorrectly. 11:40 These soldiers were programmed to think that your thyroid is a bad guy. 11:45 They go out, they basically start a war and beat it up. 11:48 That's why over time we can look at a thyroid gland on an ultrasound and we could see that it's smaller. 11:54 It's like it has been eaten by jaws on all sides. 11:57 And it just looks kind of funky. 11:59 That is years and years of your antibody soldiers picking on and destroying your thyroid. 12:06 Well, it is true. 12:07 Again, in my practice, we see it all the time. 12:10 You can come in and see somebody is like, no, my thyroid is normal. 12:14 No, it ain't. 12:15 You know what I mean? 12:16 And like you said, low and slow versus hyper, which is, you know, high and not too dry. 12:19 So it's a situation to where, once you can kind of see that, I think the thyroid and the adrenal glands are two of the most underutilized glands in the 12:28 actual body. 12:29 And they are, and I don't know if you'd agree, pretty much inevitably mixed together, if we will. 12:35 When somebody has adrenal fatigue or adrenal stress, they're going to see through the actually thyroid, vice versa. 12:39 Do you kind see when you start testing? 12:42 Absolutely, because I always tell my patients cortisol needs T3 and T 3 needs cortisol. 12:46 They play in the same sandbox. 12:48 Your adrenals and your thyroid play the in same sand box. 12:51 Yep. 12:51 No, very true. 12:52 Usually when you see too much cortisol, what happens is the conversion of T three into T four in periphery goes down. 12:57 And your body does not want to catabolize. 13:00 So it just doesn't say, let's stop. 13:01 Let's build up the T4 and all of a sudden now you have an issue. 13:04 Then comes my favorite thing to test that no doctor I know of, but I knew you do test for is reverse T-three, correct? 13:11 Right? 13:11 I mean, that's like the ultimate warm there. 13:14 And if people sit there and the doctors that do tests for don't understand the actual conversion ratio of that, you know, 13:20 T3 to reverse T 3, which I think is just, it's probably one of the most in all functional biohacking, regenerative, anything you want to paint this wellness 13:28 industry as that is probably the one most pivotal factors when it comes to any thyroid testing is seeing the actually rates between reverse t3 and actual 13:37 t 3 itself. 13:38 Would you say so? 13:40 Oh my goodness. 13:41 Yes. 13:41 And can I add on to that too? 13:43 I've recently been saying this to my community that the number one way to know, and this applies to functional and integrative medicine too. 13:52 The number way way know if your practitioner that you're working with, whatever their letters are after their name, if you are a practitioner knows anything 14:03 about the thyroid, Do they test reverse T3 and do they actually look for the optimal number for reverse t3? 14:12 Because I gotta tell you, Dr. 14:13 Ivan, I've seen a lot, we've had a lotta patients come from functional clinics. 14:17 There's no reverse-T3 on the test. 14:19 Checking boxes, and again, that's traditional and even nonsensical functional medicine doctors.
Hashimoto's Antibodies and Autoimmune Thyroid Disease 14:25 Again, you gotta think, in this industry we're in now, which has become the largest industry in medicine, it's The amount of people who are transitioning 14:33 into this industry now who have no clue what they're doing yet parading as, oh, I have a million followers, this, that, and the other. 14:38 It's pretty terrifying. 14:40 And the fact is, you know, reverse T3 is probably one of my favorite things to catch anybody on who's, who who was one those false profits. 14:46 I think reverse three, the most under diagnosed or under tested for hormone on the market, I would say probably. 14:54 Yeah, yeah, for sure. 14:55 And it's nice to talk to somebody who actually understands that, and the whole reason I understand that was of course, yes, 15:01 that I was guilty of doing the side of most spike back in the Mr. 15:03 USA days and all that kind of stuff. 15:05 25, 50, 7,500 all the way back down was kind of that, that whole, you know, trick trick in the book, but you always have to monitor reverse T3. 15:14 And that's probably one of the biggest things. 15:15 Someone will come in, they have a normal thyroid. 15:17 You can just look at somebody and be like, yo, your overweight. 15:20 There's several different factors that you can pick out once you start to understand how the thyroid works. 15:24 It'd be, like we should check a reverse t3 and nine times out of 10, it comes back high or that ratio is off. 15:29 Can you explain the actual ratio between reverse to three and T three? 15:33 So when we're looking at, well, yeah, yes, and let me back up. 15:37 It's just for the honor to know. 15:39 You were the guru. 15:39 I'm just filling in blanks here. 15:41 Love it. 15:41 Analogies, stories. 15:49 So when you're taking that synthroid, so everybody's sitting there, you got your synthroid, and you've got to leave. 15:54 Oh, yeah. 15:54 Your tear is sent. 15:55 You're taken that T four or you even taking natural desiccated thyroid medication, armor, NT, ren, thyroid, WP. 16:04 That contains 80% T4. 16:06 So that T-4 hormone has two paths it can choose. 16:11 It can go down the path and become free T3, your active thyroid hormone. 16:15 That's what gets to your cells. 16:17 Or it could become reverse T 3. Now reverse t 3, I want you to think of it like a bouncer at a club. 16:25 So reverse D3 is standing outside of your cell door. 16:30 It's blocking it. 16:31 Blocking the entry and it's looking at the T3, trying to get in, going, yeah, you're not, coming in tonight. 16:37 You're having a whiskey saying no, no chance, right? 16:40 No, no chance. 16:41 You're not coming in. 16:42 So if you think about it that way, that the reverse T3 is literally blocking your receptor site. 16:48 Now there are practitioners out there that go, it doesn't actually block the receptor sites. 16:52 This is the perfect way to understand it. 16:54 It's preventing T-3 from doing its job. 16:58 Number one, we look at reverse D3 in and of itself. 17:01 Is it under a 12? I want it less than 12. I'll accept less then 15. If your free T3 looks pretty and you are feeling like a rock star, 17:12 if you're saying that I don't have any symptoms and your reverse T three is a 14, 15, I'll go, okay, well then we're just going to keep an eye on it because 17:19 you were feeling amazing. 17:20 That's cool. 17:21 But if your feeling garbage, then no. 17:23 Now that ratio, Dr. 17:25 Ivan, i don' use that that much. 17:27 I only look at the actual number. 17:29 i want that reverse less than 12. What do you look after the ratio? 17:33 You're 100% because the whole concept is the amount of it plus how the patient feels. 17:36 And I think a lot of people get bogged down in the actual lab tests and I was a patch Adams, which was probably the only reason I'm in medicine and practice 17:43 like I do crazy and whatnot is you want to treat the patients, not the lab. 17:46 You know, our labs are kind of a guide and you know who cares if the labs says that the patience feels fantastic. 17:51 If it's not broken, don't try and fix it. 17:54 And you know, I think when it comes to the thyroid, that's probably one of the biggest things that is broken, but we don't know it. 17:58 And we start dumping things like estrogen and testosterone and growth hormone and peptides and NAD and all these other things, 18:04 they get such good buzz worthy Instagram, social media nonsense going on. 18:07 Nobody is really talking about the thyroids because everybody is so scared of it and rightfully so. 18:11 I mean like, can you touch on when thyroid supplementation or thyroid replacement can go wrong? 18:17 Sure, absolutely, yes. 18:19 Gosh, and by the way, you're like a brother from another mother. 18:23 We didn't even know that we were connected at birth, but now we're finding out. 18:26 Right, I mean, come on, it's all the fitness industry. 18:28 SEO Paisano's here. 18:30 Seriously. 18:31 So yes, absolutely. 18:33 It can go wrong. 18:35 Go wrong in one of two ways. 18:37 Number one, you can be under-medicated, which that's the majority.
Adrenal Stress, Reverse T3, and Thyroid Testing 18:41 The majority are placed on T4 and really the stat, I heard this given at A4M, the Academy for Anti-Aging Medicine. 18:48 There was a lecture being done and this woman said it beautifully and I agree with her mostly. 18:54 She gets up on stage and she's talking about the thyroid, I would say a hundred percent need T4 and T3 or T three only. 19:00 I've never met a soul that is thriving and living their best life on T four only, so being under-medicated or improperly medicated will leave someone in 19:10 that hypothyroid state. 19:12 And besides the symptoms, the weight gain, fatigue, hair loss, we have to realize that it is affecting our glucose metabolism. 19:22 You can be a type 2 diabetic on carnivore if your thyroid is in the toilet. 19:28 It starts affecting the surveillance system for cancer cells. 19:34 You know, we have this surveillance system that's looking for those mutated cancer cells to go out and destroy like FII We all have cancer sells like don't 19:43 be yep Exactly. 19:45 So it's it spans disease states as well now on the other side We can be we can go hyper but truly hyper. 19:53 I love that. 19:54 You're right You know it. 19:56 You're going to be icky and sticky. 20:00 Like, listen to the term hyper. 20:01 What do you think that means? 20:04 Hyperactive, hyper hyper, like you feel like, you drank 10 Red Bulls, Like you're gonna know, it before it shows up on a lab for goodness sake. 20:12 So true over medication. 20:14 I don't see that often. 20:17 Most of the time I'm seeing the other side. 20:19 No, for sure. 20:20 Another big thing when it comes to T4 only supplementation is the scary fact is when T-4 is placed in a specific environment, 20:26 it's going to start converting to more T3. 20:30 So you can actually have a syndrome where you're sitting there trying to replace a jinky thyroid by giving T 4, even if T four is a part of a T three complex, 20:38 whatever it could be, and you just making the system worse. 20:41 The thyroid medication you take it because it contains T for that T, four just gets converted into T 3, T or reverse T from reverse to reverse, 20:47 to three. 20:48 And then it takes months to get rid of that. 20:50 Does it not? 20:51 Yes. 20:52 Yes, it does. 20:54 Because, you know, sometimes you have to pull the T4 completely. 20:56 Completely a lot. 20:57 You have a reverse T3 and a 30. It's like... 21:00 Oh, yeah. 21:01 That's just straight side of mills, straight T 3 and nothing else. 21:04 Or T 4 you put in there, your terrible. 21:06 A lot of endocrinologists, which is sad. 21:08 I mean, I'm in no way an endocrinologist. 21:10 And I am a student of life. 21:12 For me to go through it, and I think thyroid is probably Out of all the nerding out I do on my dog walks and whatnot, I think thyroid is probably my most 21:19 enjoyable one from what iodine is versus what can prevent iodide from binding to the uracil and everything else in the system to like the whole pitfalls 21:27 of treatment. 21:27 I'd think it's fascinating because it literally is your gas pedal. 21:32 Yeah, no it is and it runs your entire body and that's why I'm really screaming it from the rooftops and thank you for helping me scream it for the rooftop 21:40 because I don't know if you've noticed this trend, it's like we have 5,000 perimenopause books, we got 10,00 menopausal books. 21:48 That's good that we're finally getting a little bit of a spotlight on women's health and hormones, right? 21:53 But again it like, what about the master gland over here? 21:56 I like waving flags like The one that actually controls your perimenopause and menopaus. 22:02 Can we talk about that? 22:04 Yeah, no. 22:04 And again, it's such an important one. 22:07 Let's jump into conspiracies for a second. 22:09 What about things like fluoride and bromide, and all these other things that sit there and displace iodine? 22:14 I mean, there is no thyroid without iodide. 22:17 So the whole concept is we've been shoved fluor... 22:20 I remember going up in class and they gave me that pink pill and you just swish it around your mouth. 22:24 Basically, I was killing my thyroid. 22:26 Every time I did that, you know, and you have that in the water systems, this, that and the other. 22:31 So I think, one of the biggest things I test here is heavy metal toxicity. 22:34 Seeing things like arsenic and bromide and all these different things, what they do to not T4 itself is the actual, even before T-4 and T3 is made from 22:43 the conversion, correct? 22:44 Yes, absolutely. 22:46 They're so toxic to your thyroid. 22:49 they push up reverse D3, they are carcinogenic, so they will cause cancer as well. 22:55 And the only thing that displaces them, basically pushes those toxins off of your cell is iodine because they're competing for the same receptor. 23:05 We can go back to seventh grade chemistry. 23:07 the periodic table of elements. 23:10 Remember that. 23:11 So when you look at that, iodine is right next to the other toxic halides and halogens, fluoride, chlorine, bromine, the things we're exposed to every 23:21 single day, every day. 23:23 And I mean, does it blow your mind that there are practitioners out there telling people to avoid iodide? 23:29 Like, I don't get it. 23:30 The sad thing is it used to, but after being in this industry for 16 years, not at all. 23:35 I mean, like with, with how everything is organized. 23:38 Thyroid dysfunction is probably a multi-trillion dollar industry. 23:42 When you look at. 23:43 All the downstream from it. 23:44 You know what I'm mean? 23:45 If your thyroid's off, you can name pretty much every single disease that can be linked to something being wrong with the thyroid or an undiagnosed thyroid problem. 23:53 Like we just talked about testing TSH 3T4 and 3t3. 23:57 Congratulations. 23:58 you're doing one third of your job. 24:00 Having the thyroglobulin, the TPA is great. 24:03 Reverse T3 is critical in everything because again, stress breeds more T-3 and we live in the most stressed population of people ever in history of humans. 24:13 I mean, more so than the back in days, you know what I'm mean? 24:16 Like when you're chased by bears, our phone, amount of stress the phone causes both emotionally, physically and even just environmentally is bananas. 24:25 So the fact that reverse T 3 and thyroid like you said, great menopause is getting, you know, Hey, congratulations. 24:30 That's great. 24:31 I'm trying to get andropause and somatopaus and adrenal pause going. 24:34 You know what I mean? 24:35 But the whole fact is thyroid, it's everything without the thyroid and nobody wants to pay attention because again, there are risks with it. 24:41 If you, if you give somebody too much thyroid. 24:44 And again that's hard to do. 24:46 pure rocker to do it. 24:48 But I mean, that can hurt somebody. 24:50 You're going to almost be doing it on purpose. 24:53 Kind of like what you were saying. 24:55 It's mostly the under actual conversion of the actual thyroid that people are being forgiven. 25:00 What is your favorite go-to combination, Phil, when it comes to T3, T4? 25:03 If somebody was going start as a physician watching this, what are you going mostly be like, well, this is probably the most best ratio of T 3 to t4 to
Thyroid Medication Options and Dosing Strategies 25:12 start somebody with who seems to have a thyroid issue? 25:15 I'm gonna give you two answers. 25:17 So when I get asked this by the general population, my audience, patients, I go, the one that works for you and the combination that work for and dose 25:26 that worked for, that's my favorite. 25:27 Cause everybody's different. 25:28 However. 25:32 However, if I had to choose, so if we're taking someone that's on craptastic T4 only that is not going to work and we are moving them into a better place, 25:43 then let's at least start with adding in 5 micrograms of T3 twice a day and let us tie trade up from there and monitor them and their body and how are 25:54 they responding. 25:55 educate that patient to listen to their body, communicate with us upon any signs of getting a little bit hyper so we can be on top of it and adjust the dose. 26:04 That's if we're going with the, what I call the biosynthetic. 26:07 So that's your, your Synthroid, Levotiracin, Tiracinsul paired with The Liothyron Incitamel. 26:15 They are, don't put them in the synthetic category and think that they're bad. 26:19 I called them biosinthetic, They're perfectly fine. 26:23 I'm on straight up lyothyrony and have been for 30 years, I am good. 26:27 But then we do have the natural desiccated thyroid and the compounded T4 and T3. 26:33 So that's where NDT, we're taking a pig's thyroid gland, drying it out. 26:37 That is actually the OG thyroid medication from the 1800s. 26:40 so that is how we used to treat thyroid is we just dry out a pigs thyroid glands and give it to you. 26:45 You'd eat it and you'd be good that is around 80% T4 and around 20% t3, give or take. 26:52 So for patients that have an elevator reverse T3 or they tend to push that way, maybe we just use like 30 or 60 milligrams of armor. 27:02 And then we add in some liothyronine to change that ratio because we can control the ratio. 27:08 Maybe Susie Q needs 70% for T four and 30% to three and John over here needs 70% T3 and like 30% for T4. 27:19 So we can compound it like that or we could add in T 3 with the NDT to change that ratio. 27:24 I think a big thing to kind of point out as well, naturally our body produces more T4 than T3. 27:29 I believe it's a 14 to 1 ratio, if I'm not mistaken. 27:32 Don't quote me on that now. 27:34 It's just a situation. 27:35 That's why you're going to usually see a much higher T to a T 3 ratio in it. 27:41 And again, like we had touched on before, If they have reverse T three creeping up, I would say get that T four completely out of there. 27:47 Would you agree or would you still keep just little bit of T 4 in there? 27:51 Depends where the reverse is. 27:53 Like if they're right at that border and they float around like a 15, 16, maybe I'll keep a little bit at T4. 27:58 Cause I always say T four is like your savings account and T3 is your checking. 28:04 If you can have a bit in savings, we all want a lot bit tucked away for a rainy day. 28:09 So we can some in saving, then we do that, but we have some over here in checking that we're spending from. 28:16 People like myself, I have to go all checking. 28:19 I can't have any in savings because I'll go hypothyroid. 28:23 So I've to put all of it in checking, i.e. 28:26 T3 only. 28:27 It really depends on where that reverse is. 28:29 If it's above a 20, hands down, we'll pull the T4. 28:34 Are you multi-day dosing or is it just once in the morning or how are you doing with that? 28:43 Twice a day. 28:44 I mean, some people have to go three times, you know, if they, If they just can't take, let's say a bolus of even five or 10 micrograms at once, 28:51 Let's split it up over three. 28:53 But yeah, twice a Day will suffice. 28:57 Yeah, it's more of a natural kind of, you know, fluctuation, if you will, on that. 29:02 That's definitely super helpful. 29:03 And again, I loved your whole analogy of the whole bouncer not letting people in. 29:08 It's basically like, T3 and reverse T 3, they're exact isomers of each other. 29:13 One's a key that works and one's the key goes in the hole and doesn't work. 29:15 You know what I mean? 29:16 So yeah, I think that's a great, great way to explain how detrimental reverse T3 is to not only life, but lifestyle. 29:25 You know what I mean? 29:25 We sit here and talk about all these fun things like fitness and fat loss and all that kind of stuff. 29:29 But when it comes to your thyroid, if it's not working, you were 100% right with the whole immune system. 29:33 You can't pick out cancer cells, your brain isn't working correctly, you're not myelinating correctly. 29:37 You're having all these different autoimmune things kind of go wacky on you. 29:40 So yeah, I think thyroid is probably where every physician should start if they're going to jump into functional medicine. 29:46 you start at the top, most important. 29:48 Thyroid adrenals, those are your major stresses, metabolism and everything kind trickles down far from there, right? 29:54 Yes, absolutely. 29:56 And actually to piggyback on your Parkinson's comment, there's been a recent study that I just came across that shows that a non-optimized thyroid, 30:05 not just hypothyroidism, but a truly non optimized thyroid meaning you're diagnosed but you are not being treated properly, 30:12 significantly increases your risk of Parkinson. 30:14 Yeah, it's insane, the whole malination process and thyroid hand-to-hand, you know.
Thyroid Health, Toxic Halides, and Broader Disease Risk 30:19 Well, I got to say Dr. 30:21 Amy, It has been probably one of the most enjoyable podcasts I've had for a long time. 30:25 You know what I mean? 30:25 Like, and at the end of all the podcasts, always like to ask two questions and I'm super enthusiastic to hear what you have to save. 30:32 First and foremost, number one, for any doctor, practitioner, anybody with those letters after their name, who wants to jump in the old wellness industry, 30:39 whichever branch it may be, What's the best advice you can give them from getting basically started out or perfecting the practice they already have? 30:48 That's a good one. 30:48 Okay. 30:49 So two things, I love what you said in the beginning. 30:52 If a doctor doesn't order labs, they're not a Doctor. 30:54 I also say if a Dr. 30:56 says no to the labs that you want to order, it's time to get a new doctor. 31:03 test thoroughly, right? 31:05 Just you want to get that full picture of your patient to be able to help them. 31:11 Don't be dictated by insurance because insurance is gonna slap you if you put on a reverse T3. 31:16 You need all of the information. 31:19 And then just like I tell patients, I'm going to tell this to any practitioner as well. 31:24 If you don't ask your patients these four words, if the patient doesn't hear these words from their practitioner, then you're not doing your job as a practitioner. 31:36 They need to go find somebody else. 31:38 You ready? 31:38 You got to write these down. 31:39 I love it. 31:42 How do you feel? 31:44 Yes. 31:44 Treat the patient. 31:45 I love it. 31:46 That's fantastic. 31:46 It goes back to what we were talking about, Patch Adams, right? 31:49 How do you feel? 31:50 Because those are key. 31:51 Those are the key, you want the labs, the data, and then you the subjective because your patient is a living, breathing human being. 32:00 And regardless of whether you think they're crazy or they are making it up, it doesn't matter. 32:03 Listen to them and ask them how they feel and pair that with the lab because that's going to make sense. 32:09 You, you, nailed it. 32:11 I'm not going to lie. 32:11 That was perfect. 32:13 The second follow-up one you already kind of hit. 32:15 If you're a patient who's now been so used to the whole seven doctors and still undiagnosed like you went through, if you could go back and give yourself 32:23 some information on doctor number six or any patient, who has come to this industry being like, I want to check out this wellness industry because I don't 32:30 feel good. 32:31 What is some insight or some, some sensei type information you can tell patients to look out for when selecting the correct. 32:40 This is so good. 32:41 I actually have a full chapter of this in my book too, but I'm gonna break it down. 32:46 So whether you are making an appointment with an insurance-based provider or you're going to pay out of pocket for a functional or integrative provider, 32:57 What I would have done, if I could go back, is I'd have made a phone call and I'll have asked questions before handing over my copay or before handling 33:07 over any form of payment whatsoever. 33:09 Such as, do you use T3 in your practice? 33:12 Do you have a cap, meaning an upper limit of how much T-3 or Arm or Thyroid you will use? 33:19 Because if they have cap that means they don't practice personalized medicine. 33:23 They're practicing their form of medicine, whatever's going on in their head. 33:27 If they only use natural desiccated thyroid medication and not T3 or T4, that's a huge red flag. 33:34 That's not personalized medicine. 33:36 So I would have asked all of those questions before I even made the appointment.
Advice for Practitioners and Patients 33:39 I wouldn't have wasted my time. 33:41 I love that. 33:42 No, very true. 33:42 And again, these are all common sense answers to questions that nobody asks, which I think are the most important things when it comes to this industry. 33:51 Because again we are in an industry that is basically a reflection point in medicine as a whole to where people are done being lab rats or being down that 34:02 factory based aspect of it. 34:03 So this has been an absolute delight. 34:05 Dr. 34:05 Amy, tell me about your book, where I can find it and where can I find out more about you? 34:09 Yes, absolutely. 34:10 Thank you. 34:10 So finding more about me, you can go to DrAmy.com, D-R-A-M-I-E. 34:16 And from there you could book a call with my team. 34:19 If you're interested in working together, we've prescribed to all 50 states, telehealth right from the comfort of your home. 34:25 We specialize in thyroid hormones. 34:27 That is our jam. 34:29 The book is called The Thyroid Fix, and I'm touting it as The thyroid Bible, the last thyroid book you will ever need. 34:35 And it will literally take you even if you're not sure, even, if, you know, like, oh, wow, I think I have a thyroid problem. 34:41 I've had a lot of those symptoms, but I don't know. 34:44 I got you. 34:45 So we walk you through a self assessment. 34:47 We walk through what that, that master gland does in your body, just like we talked about today. 34:53 And I literally take you, through teaching you how to read your labs, what kind of medication changes you'll need and how find and talk to your doctor 35:01 to get what you want. 35:02 All right. 35:03 I mean, I got to say this was spirited. 35:04 You know, it's nice to talk to somebody who loves the thyroid as much as I do, especially reverse T3. 35:08 The whole aspect of this thing should have been called like, you know the Thyroid Fix Reverse T-3, get your head out of your butt and figure out what it means. 35:14 But I, mean like this has been so, so good. 35:16 So I hope everybody gets to check you out. 35:18 Again, this is the Lifestyle Medicine Podcast. 35:21 We're powered by Access Medical Labs. 35:23 Get yourself checked, check your thyroid, and get ahold of Dr. 35:26 Amy. 35:27 Dr Amy, thank you so much. 35:28 This has such a delight. 35:30 Thank you so much for having me on. 35:32 All right, guys, have a good one. 35:34 Thanks for joining us today on the Lifestyle Medicine Podcast. 35:37 At Access Labs, every innovation we pursue is driven by one bold purpose, making personalized medicine more practical and accessible for patients and providers. 35:48 If this episode sparked new ideas or challenged how you think about patient care, awesome. 35:52 Follow the show and share it with a colleague who's ready to level up their practice. 35:57 Head over to our website at accesslabs.com and register your practitioner account today. 36:02 You'll get access to over a thousand routine and advanced biomarkers. 36:07 with 24-hour results. 36:09 When signing up, select Lifestyle Medicine Podcast as how you heard about us and score 10% off your first invoice. 36:17 Oh, and don't forget, drop us a review. 36:21 It helps more practitioners like you find us. 36:24 We'll see you next time.
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