Thyroid Health: Key To Blood Sugar Balance

Dr. Amie Hornaman

Hi, Dr. Bev, how are you? I am thrilled to be here.

Beverly Yates, ND

I’m glad to have you as a guest. Let’s get into it. What’s the deal going on with the fact that there’s so much overlap, particularly with hypothyroidism and type 2 diabetes pre-diabetes? What’s the deal here?

Dr. Amie Hornaman

We have to start with the fact that the thyroid is the master gland, and we know that it has control over every organ and every system in the body, including your pancreatic release of insulin and your blood sugar control. I have seen this countless times, and on average, I see insulin resistance go hand in hand with hypothyroidism in 95% of my cases. Every so often. I just met with a patient today who has undiagnosed Hashimoto’s. Her free T3 is low, the active thyroid hormone and I looked at her A1C and insulin, and it is perfect and beautiful. But that is rare. It is because she has been doing all the lifestyle changes and things she can do to control her blood sugar for years. 

In her case, she’s the rarity where you say, Okay, there’s not prediabetes here, but I would say easily in 95% of the cases of hypothyroidism, and we see that insulin resistance and we can also see it when people are doing most of the things, I won’t say all the things, but doing most of the things. They’re eating clean. They might even be on a ketogenic or carnivore diet, and they’re still experiencing high glucose, elevated insulin, and high A1C, and it’s coming from the thyroid being off because of that control. Essentially, the thyroid being hypo-low and slow is causing the body to not utilize the glucose properly. The pancreas oversecretes insulin. They get into this insulin resistance state at the cell level. That’s where we see it go hand in hand with the thyroid.

Beverly Yates, ND

That’s great to know. As we continue to unpack this and look at the details behind the scenes, when you say the thyroid is off, give us a picture, if you would, please, of what it is that people experience so that they know, Hey, it could be my thyroid that is hijacking the system. Because you, some people are doing a lot of smart things with health, but they’re sure they’re not getting the results.

Dr. Amie Hornaman

These are the big symptoms that you want to look for that might trigger you into saying, Hey, I  do need to go get thoroughly tested and look at my thyroid function. Gaining weight, and my inability to lose weight. That’s a big one. Along with fatigue, those are the top symptoms that I see in my patients. Then hair loss, constipation, mood swings, depression, anxiety, and brain fog. If you think hypo-low and slow, everything slows down, so digestion slows, hence constipation and your brain slows down. You’re not processing things properly. You’re not remembering things you used to. You’re not motivated. You don’t have that drive to get things done. You can lose the outer corner of your eyebrows or thin your hair. Your nails can become very brittle and break. There’s a host of symptoms, but those are the big ones. If you check that mental box off of those symptoms, two or three of them, let’s go get tested, and let’s check your thyroid function.

Beverly Yates, ND

Okay, great. You and I, I know we’re both fans of the whole concept of tests. Don’t guess. With that in mind, what tests should people get? Because what I’ve seen is maybe one or two tests that are routinely ordered, and it’s not enough. Take it away.

Dr. Amie Hornaman

It’s horrible. Do not go to your PTG and say you want your thyroid tested because what you’re going to end up getting is one, maybe two tests. As Dr. Bev said, You’re going to get TSH, which is thyroid stimulating hormone, and only if that is flagged high will anyone stop and say, Hey, there might be something here. There might be a thyroid issue here. Next, you’re going to get your free T4 tested, but T4 is the inactive thyroid hormone. It’s okay; let’s look at it. But that’s not an important test. The important test conventional medicine usually leaves off and doesn’t test. They’re important tests that you want to get free T3 because T3 is the active thyroid hormone. Just as we said earlier, the thyroid runs the show; it runs your body. Every cell in your body has a receptor site on it for T3. If you don’t have enough T3, you’re not going to have a metabolism, you’re not going to grow your hair, you’re not going to think straight, and you’re not going to poop every day.

That alone, that marker, that free T3  is vital to know how much active thyroid hormone you are making, converting, and utilizing in your body. Then we look at reverse T3, and reverse T3 is the anti-thyroid hormone. I always give an analogy. The analogy I’m going to give for this one is that it’s a bouncer at the club; it’s a bouncer outside of your cell door that beautiful active T3 is floating around. It wants to get in and wants to attach to that receptor site. But if you have too much reverse T3, it’s standing outside the cell door, blocking it, basically telling T3, you’re not getting in today, you’re not getting in the club, you’re not getting in to do your job, and it’s going to leave T3 in the bloodstream, and you won’t have a metabolism, you won’t grow your hair, and you won’t have a brain. 

Essentially, reverse T3 is built into us as a survival mechanism because if you are injured, if you’re battling a trauma, a traumatic disease injury, the reverse is going to go up because our bodies know you don’t have to burn fat. You don’t have to think; you don’t have to feel good as you’re lying there fighting for your life. But all the more reason to test it when you’re not fighting for your life when you’re trying to live life and enjoy life because reverse T3 is elevated. It’s putting your body in survival mode. We want to test it every time. Do not let your doctor tell you that it’s only tested in clinical settings. We want to test it every time. We want to finally check your Hashimoto antibodies. That’s TPO thyroid peroxidase and TG, which test thyroid globulin, and those two antibodies test for Hashimoto’s.

Beverly Yates, ND

Well, okay, folks, hope you are taking notes, if you weren’t, run it back and listen to that. Those are the tests. You want to be sure that your thyroid is functioning, and if it is the culprit, one of those will give itself up, or more, as the case might be. This is undertested, underunderstood,  and underappreciated, even by an endocrinologist. Whoever you’re seeing; if they’re not ordering this whole battery, you don’t have a full 360-degree picture. What is your thyroid doing or not doing for you?

Dr. Amie Hornaman

There’s a rule that if your doctor says no to testing, it’s time to get a new doctor because if you have to beg and plead with your doctor to check your numbers, there’s no money out of their pocket to write a lab script for you. If you have to beg your doctor to write a lab report so you can see what’s going on inside your body, do you think that same doctor is going to help you? No. 

Beverly Yates, ND

Yes. That is a full stop. Mike dropped right there. That’s the truth. You’ve hired them. You shouldn’t have to beg for this. It’s data and information. Okay, great. I knew you’d make that point. Okay, now versus aspects of thyroid, an issue they already know or suspect. They also have blood sugar issues, whether it’s prediabetes, type 2 diabetes, enzyme resistance, or polycystic ovarian syndrome. Perhaps they’ve had a history of gestational diabetes. Other things on their glycemic control spectrum. What are some things that are myths that would be good to bust here that are common knowledge that’s wrong?

Dr. Amie Hornaman

Now, surrounding blood sugar and insulin,.

Beverly Yates, ND

Blood sugar, insulin, and the dance with the thyroid system—I think people get lost on this one.

Dr. Amie Hornaman

The dance of the thyroid. Absolutely. From what I see in my practice, a lot of patients will come in, and they might be doing a low-carb way of eating off the bat because they read or heard somewhere that this is going to help them lose weight and it’s not. This is where we say, okay, this might be a great nutrition plan, a great diet, and a great way for you to eat and incorporate this into your life. However, you’re not going to get a reward for your efforts if your thyroid is off. We want to do both at the same time. I never say, Just forget that low-carb eating until we get your thyroid back online. No, we want to do it both at the same time. We want to do things to address what we’re seeing in your labs, whether it’s an elevated A1C or an elevated insulin level. We want to address those things. We want to even address high glucose. If you’re throwing on a CGM and you’re finding out that some of your Keto foods, which this was me, your keto foods are jacking up your blood sugar, well then, you got to cut those out because that’s giving you data. You’re going to be changing your diet and your lifestyle over here, while at the same time, we’re going to be optimizing your thyroid. Then you get rewarded for your effort; you get a little bit of a bang for your buck. You’re doing all the work over here. 

You’re changing your diet and your lifestyle. You’re exercising because you’ve heard Dr. Bev tell you that this is going to help lower your glucose. Lower your insulin, how does it balance you out? You’re doing all the things, but you’re not getting rewarded for them. It’s very easy to slip into what I call screw-it syndrome. Where do you go? I might as well just eat the pizza because nothing that I’m doing is working anyway. But you want to do it both together, so you want to continue with your lifestyle changes and your diet changes. I love Berberine. I love Berberine for bringing down a balance in our blood glucose and insulin. Maybe throw that in the mix as well. But then over here, let’s get into optimization of your thyroid, and then it’s just a beautiful dance together.

Beverly Yates, ND

Absolutely. You will have those partners all synched up so they can dance and not step on each other’s toes and fall over in a heap.

Dr. Amie Hornaman

I like that. Yes, exactly.

Beverly Yates, ND

In that journey, what are some other myths that people might not quite appreciate, particularly as they apply to women’s health or perhaps men’s health? Some issues that can go on around sleep, are insomnia, anxiety, the overlap with thyroid issues, and blood sugar control. 

Dr. Amie Hornaman

Okay. Yes. Sleep. Sleep is a big one. We know that if you don’t sleep, if you’re getting a minimal amount of sleep, or maybe you’re a night owl and you’re, well, I just don’t go to bed until 1:00 in the morning. You are missing out on rest and repair, and you’re going to throw off your blood sugar. There is a study done, and it’s stuck with me forever. I saw this study probably ten or 15 years ago, where they took twins and put them in a sleep lab. We know that DNA genetics, all the same, controls their environment, what they eat, and the amount of activity that day. Everything was controlled because it was in a lab. They put these twins in a sleep lab, and they controlled everything, of course. The one twin, what they did was wake him up out of REM sleep. They didn’t wake him up, but they just kept him out of that deep REM sleep. What they found was that within 3 to 5 days, that twin was developing insulin resistance. It was moving into full-blown diabetes. That is how impactful sleep is on your blood sugar. It’s amazing. Many of us don’t; we chalk it up to I’m a night owl. I don’t need that much sleep. Well, that doesn’t mean that’s not dictated by you. That’s dictated by your body and your creator. Yes, you do need sleep, and that’s huge for inflammation, blood sugar control, and weight control. We know that people will gain weight when they are not sleeping. It’s directly tied back to that blood sugar and insulin response.

Beverly Yates, ND

Yes, definitely. I feel there’s a lot of stuff around metabolism that isn’t well explained and understood. People sometimes tend to either sprinkle fairy dust and have magical thinking or they make stuff up. It’s complete bullshit. It’s not accurate. Here we’re talking about the science, the facts, and what is going on behind the scenes. Okay, so now that we’ve had a chance to peek at what sleep does and its importance to metabolic health, thyroid health, and blood sugar control. What’s the situation for the thyroid when someone is chronically stressed, and how might that affect blood sugar? Everybody on the summit, I’m sure for any of these episodes, has already heard about the intimate tie between cortisol and stress response hormones and blood pressure release in response to cortisol. What’s the deal with thyroid at that moment?

Dr. Amie Hornaman

Okay, the body’s just so beautiful and so interconnected. It’s just that having stress equals an increase in cortisol, usually. Most people under stress will overproduce cortisol. Now that elevated cortisol, as you’ve talked about, increases blood glucose, your blood sugar is out of control. We know that there is a direct correlation between walking around with high glucose levels and Obviously, you’re going to have an elevated A1C, and oftentimes we see elevated insulin levels. 

Now I like insulin to be below a six. If you’re over six, to me, that is insulin resistance. Some people have cut off at five; some people have a little bit higher. I was around there. If you’re above that in your insulin, that’s an issue. What we see with that elevated cortisol is that not only is it pushing up your blood sugar and your insulin, but it’s also creating an inflammatory environment. When we’re talking about the thyroid, the thyroid cannot work well when you’re inflamed. The thyroid does not work well at all with high blood sugar and high insulin. We see that that back-and-forth plate, 

We said earlier that the thyroid is the master gland. It’s going to disregulate and throw off your glucose control and your insulin control, but backward that elevated insulin, that inflammatory state that you’re in, is also going to downregulate your thyroid production of T4 and T3. The other thing is that it’s going to have to do with high glucose and high cortisol. Now you’ve got a double whammy going on. It’s going to push up your reverse T3. It’s going to push you into that survival mode that we talked about earlier that we don’t want you to be in unless you’re lying in a hospital bed fighting for your life. I don’t want you walking around with an elevator reverse T3. We know that high cortisol and high glucose go back to the thyroid, which stops that conversion from properly happening from T4 to T3.

Beverly Yates, ND

With that, we can understand why people will find themselves in these situations where they might have this relentless weight gain despite otherwise healthy habits. We’re in a moment internationally where so many things have changed for people metabolically. We’ve got to get better information out to the general public about what the heck is going on.

Dr. Amie Hornaman

We do. We do. 

Beverly Yates, ND

With that in mind, are there any myths around the whole concept of simply eating less and moving more? That 1950s advice worked in a much, in my opinion, simpler environment. In today’s world, 50 or 70 years later, it’s, whoa, okay, yes, complicated. Help us break that one down.

Dr. Amie Hornaman

That’s what I was told during one of my six misdiagnoses of my thyroid. Did you eat less and exercise more? I think that’s the pat answer that we get from conventional medicine when we walk and say, Hey, doc. I’m gaining weight. I don’t know what’s wrong. I’m doing all the things I do well, just eating less and exercising more. Now we are in a pandemic of obesity in this country. It’s not out of line to say, Hey, some people do need to eat a little bit less and freaking move. Just go for a walk; for God’s sake, get off the couch. Get out of your desk.  There is that segment of the population where less exercise might apply. But if you’re listening to the summit, it’s probably not you. You’ve probably already done the things, and you’re taking control of your health, and you want to take control of your health. That’s why you’re here. The eat less and exercise more premise may not going to apply for you. It can create a stressful environment. 

I’m seeing a lot of ladies; you guys are notorious for this. What I’m seeing y’all doing is overfasting. Not only are you eating less, you’re not eating enough because you’re trying to do this intermittent fasting thing, which has its benefits, but you’re overdoing it, and you’re doing these OMADs, or, 20 hours of fasting and 4 hours of eating, you’re not getting enough calories. You are in a severe deficit because your metabolism is going to shut down. You’re not getting enough protein to preserve your lean muscle tissue and give you a metabolism, so eating less and exercising more can be a detriment. Same thing with exercise. We see these women going to the gym. I was one of them back in the day. I did 2 hours of cardio. I thought maybe going to the gym twice a day was a great idea.

Beverly Yates, ND

Amie, no. Too much.

Dr. Amie Hornaman

Yes. That was back in the competitive days. I’m not that crazy anymore. But you get into that desperation mode where you’re going to do anything because you don’t understand what’s going on with your body. Maybe more exercise will work. Then all that does is push up your cortisol, which then pushes up your glucose.

Beverly Yates, ND

Yes, it is that. There is such a thing as doing too much of what seems to be a good thing. It seems for most of us as humans—for women, for men, for boys, for girls, for teens, young adults, older adults, seniors, little kids, whatever. There’s a balance. If we get out of balance, this is where the trouble lies.

Dr. Amie Hornaman

Yes, exactly.

Beverly Yates, ND

Okay. One of the things that I remember learning in naturopathic medical school, and I think anybody who has the health and medical background around the thyroid knows that we have the message that it’s the master gland and that, as such, we can think of it as the conductor of the symphony. However, if the conductor is struggling, the other members of the orchestra are also going to struggle.  

Dr. Amie Hornaman

Way off,  not going to sound good.

Beverly Yates, ND

Yes, not going to sound good. Okay, we can all agree on that. What are some things people can do to get themselves to a place where they feel they are checking the boxes? We talk about the lab work we’ve talked about now, about not underexercising and overeating. We also talked about undereating and overexercising, especially for women.  They’re not taking in enough fuel, and they’re pounding themselves into the ground. Therefore, the quality of the blood sugar is up because they’re doing things. they think. But in this case, things aren’t giving them results.  What are some tips you can share about getting things back in balance?

Dr. Amie Hornaman

Yes. Okay. the things that you can do that don’t require, let’s say, medical intervention, the things that you can do. I am a huge fan of all of the minerals and nutrients that the thyroid needs. We all need vitamin D, and we all need magnesium. We are a magnesium-deficient society. You need a multitude of mags because there are different mags; why not just mag citrate that’ll make poop? But you need more mags in mags citrate. But you want more to get that magnesium blend in there. You want to get your vitamin D. You want to get a little bit of selenium. I’m not talking about going to town on 200 to 300 miles of selenium every day. I mean, eat a Brazil nut or two. That’s all you need to get your selenium in. Then finally, iodine. I know this is controversial when we’re talking about iodine in the functional medicine community. We have half of the practitioners over here. Well, I would say 40% say, No, don’t use iodine. 60% say iodine is great. I go by this science. Your body needs iodine. Every cell in your body needs that you need it to convert T4 to T3. You need it to bring down that bouncer at the club that reversed T3. It is fantastic for thyroid nodules, fibrocystic breasts, uterine fibroids, growing your hair, having energy, and fighting off viruses. Iodine. 

You want to just use the amount of iodine. That alone can often help get people’s thyroids back online without needing to go into thyroid hormone replacement. Now we can use black cumin seed oil as well, which also has an impact on balancing your glucose and insulin. We’ve seen black cumin seed used with type 2 diabetes to help better control glucose and the insulin response. Guess what? It takes down inflammation, and it takes down Hashimoto antibodies. It is a beautiful thing. Just sometimes doing those simple supplemental interventions is all you need before you have to move into, maybe, finding a specialist to give you the proper thyroid hormone replacement.

Beverly Yates, ND

These are straightforward things that people can do. They can assess. First of all, do I have a problem? Secondly, I remember meeting myself to a pulp, and I’m still not where I need to be health-wise. In three months, I can take charge of it. Here are some things I can do for myself, or I can work with other health professionals who understand this and can guide me to where I need to go. The standard approach might be completely inadequate here. This is a classic one we learned. What was that over 30-plus years ago when I was in school, and it’s still an issue with my thyroid? It was an issue three decades ago, and it continues to be an issue.

Dr. Amie Hornaman

It does. It’s even growing now because we’re in a more toxic environment than we were 20 or 30 years ago. Now more than ever, we have to keep an eye on our thyroids and how they’re functioning and do something about it.

Beverly Yates, ND

Perfect. Thank you so much, Dr. Amie Hornaman, for being my guest here on this episode. I appreciate your insights and wisdom and hope that people will connect with you. Where can they find you?

Dr. Amie Hornaman

You can go to dramiehornaman.com if you’re interested in working together. If you’re interested in diving into any of the supplements that I have, I do carry black cumin seed oil in the form of Hashimoto’s Fixxr because I use it all the time with my patients. Then you can also find me on the Thyroid Fixer podcast on all social media under @dramiehornaman.

Beverly Yates, ND

Would you kindly spell out your name so that people can get it right?

Dr. Amie Hornaman

I will, yes, because we don’t want to type it wrong. it is. A M I E H O R N A M A N

Beverly Yates, ND

Great. Thank you for that. I appreciate you. All friends, you know what to do. Please share these episodes with anyone who cares about their health or who could benefit from this information. Maybe you’re already knowledgeable about these things, about thyroid. Share it and spread it. Let’s make sure everybody is well informed. Thanks, folks.