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About Dr. Amy Myers
Amy Myers, MD is a renowned leader in Functional Medicine. She has helped tens of thousands around the world recover from chronic illness through her dietary based program, The Myers Way. She has created multiple interactive eBooks and eCourses to guide readers through her revolutionary approach to health. Her blog serves as a beacon of hope to the many sufferers of chronic disease and autoimmune conditions.
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Books Discussed in this Episode
Mike: Hey, folks, welcome back to High Intensity Health Radio. It’s Mike Mutzel here. I appreciate you tuning back in to episode number 156. Today we’re live with Dr. Amy Myers, The New York Times bestselling author of The Autoimmune Solution. Today we’re going to talk about thyroid dysfunction and she has a new, great book coming out. If you’re watching this video it will be available called The Thyroid Connection: Why You Feel Tired, Brain-Fogged, and Overweight – and How to Get Your Life Back.
Dr. Myers, I really appreciate you coming on. I think a nice transition to launch this whole discussion of thyroid dysfunction is how ubiquitous autoimmune thyroid and thyroid dysfunction is. I hear from so many practitioners I work with, they themselves like you have a story as to how you got into functional medicine involving thyroid dysfunction. Why is this condition so ubiquitous and pervasive especially among women?
01:59 Thyroid Dysfunction Prevalence:
Amy: Yeah, so I think that … First of all, there are about 27 million Americans with thyroid dysfunction whether it’s hypothyroidism, hyperthyroidism, thyroid nodules, thyroid cancer and about 60% of people don’t even know that they have it. Some might argue, oh, we’re better at picking it up. No, we’re not, we’ve been doing the same tasks for years and years. The tasks are actually antiquated blood testing and it’s a pretty easy thing to pick up.
I think one of the reasons why I talk about … obviously multiple reasons in the book about why this is so pervasive, I think one of the biggest causes for thyroid dysfunction these days is really this low iodine. Or the fact that relative proportionately to the amount of toxins that we’re being bombarded with every day, the halides or halogens on the periodic table, iodine is right next to fluoride, chloride, and bromide and these are ubiquitous in our environment these days. We are brominating all of the baked products that we eat. There’s bromine in flame retardants, in all of our furniture, in our mattresses. There’s, of course, chlorine and fluoride in water that we’re drinking, in our
food supply, so we’re getting less iodine in our diet these days.
Then we’re being bombarded with much higher amounts of these other halides and so they displace iodine in the body. The highest concentration of iodine in the body is in the thyroid and we need iodine in order to make our thyroid hormone. Of course, I can go into a whole lot of other examples, but I do feel that’s one of the biggest reasons in addition to our highly processed diets, we’re eating a lot of gluten, we have leaky guts. There’s more infections that we’re realizing through molecular mimicry can stimulate the immune system in the thyroid gland and then, of course, our very stressful lives that we’re living.
Mike: We’ll dive into all those other factors, but let’s finish off on iodine. I think that’s a really important point. I’m glad you launched there because it’s really polarizing. In our functional medicine space some people are really for iodine and recommend molecular iodine and potassium iodide. There’s other practitioners that say don’t do that, it will
induce autoimmunity or perpetuate Hashimoto’s. As a busy clinician who treats a lot of individuals with autoimmune disorders and autoimmunity and hypothyroidism where do you sit on this supplemental iodine spectrum?
04:22 Iodine and Thyroid:
Amy: I do think again because of what I just told you that we’re not getting iodine and we’re being bombarded with the other halides that most of us do need iodine. I think what you’re referring to is what we’ve seen in functional medicine and in integrative medicine that there are some practitioners that are using extremely high dosages like Iodoral which is 25 milligrams and sometimes we’ll have people take 50 milligrams of iodine. I’m not a proponent of that. In my clinic I’ve seen people come in who’ve been doing that and 50% of them will swear it cured them and 50% will swear that it’s what created their dysfunction, so I think the jury’s still really out.
What I’m recommending to people is literally a thousandth of the dose, but in the
microgram level. I formulated a thyroid multivitamin to go along with the book and it has 300 micrograms of iodine in it, so I do believe … In my clinical practice I’ve really only found 1 or 2 people literally out of hundreds if not thousands that I’ve seen with all kinds of dysfunction, but certainly thyroid dysfunction and only 2 have really told me that they actually had a true problem or allergy or side effect with that level of iodine.
I find that in most people that it’s safe and that most people do actually need it. Of course, everybody is an individual and so you need to try and see what symptoms or how you feel after you’ve taken it. We’re talking about amounts that we would normally have gotten in our diet and then again we have just this onslaught of the other halides that we probably might need more than that. I’m not going to say there aren’t people who can’t use the 50 milligrams, it’s just not something that I use in my clinic.
Mike: Because of the risk versus reward may not be there and so forth, but …
Amy: Yeah, there’s …
06:22 Pool Chemicals and Your Thyroid:
Mike: Iodine, sorry, is all the extra thyroid benefits like breast health and fibrocystic breast disease and there’s a lot of research there, so I think it’s a great nutrient for women. As a parent of a young child, when we go on vacation or travel kids want to play in the pool all the time. We know there’s chlorine and fluoride and what not, bromine in pools. As a functional medicine practitioner do you recommend people stay away from pools with chlorine and bromine? What are your thoughts there and guidance?
Amy: I think in everything there’s risk benefit and I got asked this question on Facebook Live the other day by a gentleman who later sent me a very kind response back to my response that really put me into tears. He had fibromyalgia and hypothyroidism and I think some other things, pain syndrome, and swimming was really his therapy. I think in everything you have to look at the risk and the benefit.
In our regular water supply I recommend that people put filters on their water, on their showers, as well as the tap or a whole house filter. If you can swim in a saltwater pool or find some freshwater or a natural body of water that isn’t contaminated those would obviously be better. Taking a swim here or there or for this gentleman if he gets in there and his pain is reduced and his cortisol goes down and his stress level goes down, who am I to say that that isn’t more of an improvement than what little amount of chlorine he’s going to get. Certainly if you need to do that then you’d want to shower right afterwards. I definitely recommend that you’re probably taking some iodine which I, of course, couldn’t counsel him personally, but would recommend anybody doing that.
I think the people that really have to worry about it … Here I just told you we just moved into a new apartment and it was so hot in Austin and we’d been traveling and moving. I looked at the pool and I was like ah, I just want to go get in the pool and relax. We did
and I smelled like chlorine afterwards and I showered, but I thought that just really calmed my nervous system for the moment to get in the pool. Would I go get in the pool every day? Probably not and certainly there’s people who are doing things like swimming for exercise. I think those are the people that probably really need to take this seriously because they’re getting that big dose every day. Trying to find things like figure out what day they chlorinate the pool and don’t go that day, go a couple of days later. Just again risk benefit with everything that you do.
08:30 Stress and Thyroid Dysfunction:
Mike: Yeah, a really important point there and you mentioned the word relax and I want to tease that out and how stress can induce thyroid dysfunction. When we think about the ubiquitous nature of thyroid dysfunction in our society it makes me wonder why does that occur and you talked about stress and the inflammatory response. There’s multiple ways in which our body can either affect the thyroid-binding globulins and the receptor sensitivity and then the pituitary hypothalamus. There’s so many control points and so
let’s talk about … tease out some of those and you mentioned relaxation and stress and the inflammation connection. Can we give an overview there about how that’s all woven in?
Amy: Yeah, when we are stressed, back in the day we used to just be stressed by something like where are we going to sleep tonight, what are we going to eat, where are we going to get our next meal. Those were real stressors and then we’d find shelter or find food and that stressor would go away. Now we are bombarded with all kinds of stressors. Those for most people aren’t typically their stressors. Their stressor might be a health stressor, their stressor might be I have back to back podcasts today and living in an apartment, where am I going to shoot these things, to being available all the time on our iPhones. We’re not really getting that downtime and so what happens is cortisol naturally would go up in a stress response in order to give us the energy to run away from that saber-toothed tiger or to run towards that boar that we were going to kill or to find that shelter.
Now we’re not having that system turn off and we just have these high levels of cortisol all the time which can do several things, one of which is to …multiple things. One it cause leaky gut, it can suppress your immune system, the high cortisol, that’s how steroids work. When people have autoimmunity or inflammation they’re given a big burst of steroids. Or it can also increase your level of estrogen and when our estrogens go up it binds more thyroid hormone to proteins.
When we’re talking about the thyroid hormone it’s these unbound or free forms of any type of hormone, whether it’s our thyroid hormone or whether it’s our testosterone, it’s these free hormones that act in the body. When they’re bound to proteins they can’t act in the body. They’re bound up and can’t go into receptors. With this higher level of estrogen that binds up more of our thyroid hormone. Then, of course, that can escalate into then progesterone imbalances and it’s just this whole cycle that can spin out of
control, but those are the three main things that I think of when I think about stress.
11:13 Hormone Replacement Therapy:
Mike: For BHRT and hormone replacement therapy it’s pretty hot right now. What you mentioned is disregulated cortisol function can affect free levels of thyroid hormone which affects every cell and mitochondria in the whole body. In your opinion, I see a lot of folks jumping into hormones, would you address the thyroid first before you look at any sex hormone regulation?
Amy: That’s a great question. Yes, I do, but also backing up from that address the factors that I talk about in the book. I address the diet first and I address the gut first and then we’re looking at things like toxins, infections, and stress. Certainly when somebody comes in … Like myself I had Graves’ disease and had my thyroid ablated by iodine-131, so I don’t have a thyroid. If I have someone like that in my clinic I’m not … Of course, I address all these other things, but if they need thyroid replacement hormone we get on that.
If there’s somebody who’s had a hysterectomy or somebody who’s post-menopausal … Usually when we’re addressing these other factors first a lot of the inflammation settles down and so many things get back into balance for people. Then, of course, if they need supplemental thyroid hormone that’s what we would do next. Then after that settles out if they need supplemental hormone replacement such as progesterone or natural bioidentical estrogen or testosterone then we’d go there. For a lot of people I don’t do a lot of hormone replacement for people. It’s usually the people who are already in a postmenopausal state or somebody who’s had an early hysterectomy or something like that.
12:51 Impacts of Inflammation:
Mike: You mentioned inflammation a few times in there and you talk about that in the book a lot, especially your other book, The Autoimmune Solution. I believe you said something to the effect that your autoimmune disease never goes away, something along those lines and because we all live in this spectrum of autoimmunity, so talk about that aspect and then how inflammation is linked to thyroid dysfunction.
Amy: Yeah, I don’t know if I was the first person to coin this, but I certainly wrote about it in my book and was the first person to write about this spectrum of autoimmunity in the autoimmune spectrum. That it starts with inflammation that people might brush off whether it be acne, to bloating stomach, to some joint pain every once in awhile, to feeling puffy, up to full-blown autoimmunity. I do feel autoimmunity is like cancer. Once you’ve been given that diagnosis can we reverse it meaning can we get the symptoms to go away, can we get the antibodies often to go away and can we get you symptom-free and medication-free. The answer to that is typically yes and then you move back down that spectrum.
Then you might have some new event in your life. Like me I had this recent exposure to toxic mold which is why I’m in an apartment. You might move back up that spectrum. I
don’t feel like you … There’s always this spectrum and unless you’re really somebody who’s, I don’t know, the Dalai Lama, he might not have some inflammation. We live in a real world with stress and toxins and infections and things happen to us, people get divorced, they lose their job. They have good things happen like have a baby or get married, but there are things that can push you up and down this spectrum.
14:30 Reversing Autoimmunity:
In the caveat that I wanted to say because that’s usually the spiel that I give when I’m talking about The Autoimmune Solution, the first book I wrote, but with The Thyroid Connection because I always get this comment from a diabetic mother or something about their child and why my kid can’t get off of insulin and the thyroid’s somewhat the same way. If you’re newly diagnosed we might be able to keep you off supplemental thyroid hormone, we might be able to reverse those antibodies and not have you have to go on it. I’ve certainly reversed Graves’ disease in many patients that I’ve seen where they did not have to go through what I had to go through and stayed medication-free
and have a normally functioning thyroid, even optimally functioning.
If you’re somebody who like me already had an intervention, if you’re somebody who didn’t get diagnosed for 6 or 10 years which is the average, if you’re somebody who’s been dealing with this for 15, 17, 20 years you might have already done enough damage to your thyroid or enough damage might have already been done to your thyroid that you might still need supplemental thyroid hormone and you might not be able to ever get off of that. I like to caution people that I don’t think that that’s failure or defeat. That is just what that is. If I sat every day and beat myself up for having had my thyroid ablated and that I have to take supplemental thyroid hormone I’d be getting nowhere in life.
When enough tissue has been damaged, I can’t re-grow that tissue. When it’s early enough in the process and when you ask how is this related to the thyroid and a lot of times the thyroid gets inflamed and then it becomes destroyed. So if we’re catching it in
that inflammatory state we can decrease that inflammation and maybe get off the supplemental thyroid hormone or prevent from going on it. If we’ve already gotten to that damage state where the cells are really getting damaged and the tissue is getting damaged and dying we can’t re-grow that. Therefore, supplemental thyroid hormone would come into play and I call it that because that’s exactly what it is, it’s not a medication.
As you’re hearing interviews with people and they have all these success stories I don’t want all the people out there who need to be on supplemental thyroid hormone to beat themselves up because that’s what that is. It also doesn’t mean that that’s the endpoint and that you don’t need to address the underlying cause. Okay, I’m already on it, I don’t need to get the book. If I felt that way about my condition, conventional medicine solved mine by ablating my thyroid, but if I’d never gone on to figure out the root causes of why I had it in the first place, then I wouldn’t be where I am. It’s really important for
people to still address those underlying causes to figure out why they got it, correct it and so they can improve their thyroid function and prevent something else from coming.
17:17 Increased Risk of Other Diseases:
Mike: Let’s take that one step further because you talk about it on your Facebook Live, I’ve been watching a few of those, how the prevalence of having another autoimmune disease … If you’ve had one it’s much higher, so talk about that a little bit.
Amy: Yeah, so the statistic is three times more prevalent to get another autoimmune disease. Not all thyroid dysfunction is autoimmune in nature and though the vast majority of it is and the book certainly is for anybody with Hashimoto’s or Graves’, but it’s also for anybody who has thyroid cancer, thyroid nodules, post-thyroidectomy, people who have been told they don’t have thyroid dysfunction, but they still have a lot of the symptoms. It’s not only for those with autoimmunity, but it’s those for any type of thyroid dysfunction.
Certainly if you’re not dealing with the underlying, root causes of your autoimmunity
and fixing your leaky gut then you are keeping that floodgate open for another autoimmune disease or now the thought is that cancer is … That leaky gut needs to be there in order to start the cancer snowball rolling as well. You really want to fix your gut, whether you have autoimmunity or not, but particularly if you have autoimmunity as to prevent anything more coming down the pike.
Mike: That’s what I love about your message, Dr. Amy, is because like you said a lot of people go to a traditional doctor, they get put on Synthroid, their Hashimoto’s is cured and they go about their way eating the same foods and adhering to the same lifestyle. What you’re saying is you’re at a three times greater risk or probability if you will of having another potentially life-threatening disease like cancer or multiple sclerosis, something where we may not have an easy “bandaid” or treatment for which is really …
Amy: Yeah, and when I say and I said that in my first book in The Autoimmune Solution that you’re lucky if it’s Hashimoto’s and all you have to do is take a pill. Of course, I got a lot of backlash from people with thyroid dysfunction telling me that it wasn’t easy. Trust me, I’m somebody with thyroid dysfunction, I had my thyroid ablated. I’m not going to tell you that my journey was easy, but I tell you that the treatment for that is a hell of a lot easier than multiple sclerosis or rheumatoid arthritis or something really, really … polymyositis, something really debilitating. I’m certainly not saying that to slight anybody who’s dealing with Hashimoto’s or even Graves’, but I would say that if I had to pick one I’d rather that over any of the others.
Mike: Right, right, great point. I guess now let’s go down the decision diamond of … I love how you talk about it in your book, I think derailed by reference ranges in testing. How would someone ascertain whether or not they have thyroid dysfunction or autoimmune-induced thyroid dysfunction? Talk about some of the lab tests you recommend.
20:01 Lab Tests for Thyroid Dysfunction:
Amy: Yeah, and so one of the failures … I talk about how conventional medicine failed me and it’s really my mission to not have it fail others is that one of the failures of conventional medicine is that when they’re checking for thyroid dysfunction they’re typically only doing a screening test for the TSH. That really tells you about the pituitary and not about the thyroid. If you have Graves’ disease like I did typically your TSH will be suppressed and that’s more easy to pick up than it is hypothyroidism where the reference range is so broad that a lot of people who are told that they don’t have thyroid dysfunction …
The Academy of Endocrinology really believes that the reference ranges are too broad. Then, of course, those of us in functional medicine think that even that’s too broad. Optimal is between one and two for TSH or lower, but what they’re not doing is checking for a free T3, a free T4, a reverse T3 and then, of course, thyroid antibodies. I check all of those on all of my patients.
In conventional medicine they don’t really feel it matters whether they diagnose you
with an autoimmune condition or not because at least with Hashimoto’s or plain hyperthyroidism, they’re going to treat it the same way which is Synthroid and so it makes no difference. I would argue based on that you’re three times more likely to have another autoimmune condition, that it is important to know. It puts you much further up the spectrum on obviously the autoimmune spectrum and so it is important to know because it puts you in a different category.
I just want people to know and understand that when I’m talking about all of this, that in the book it’s easy to focus on hypothyroidism or Hashimoto’s because that’s what most people have. The book is really for those with Graves’ disease as well and that I offer some natural alternatives to halting the thyroid production rather than doing the harsh things that I had to do which was PTU and then I got toxic hepatitis and then I had my
thyroid ablated. There is a whole section for those people who are suffering with Graves’ disease as well in a more natural, less-invasive way to potentially reverse that.
Mike: Do you want to dive into those details a little bit. I know you mentioned a lot of minerals and then even some low dose naltrexone. Do you want to talk about some of the unconventional treatments?
22:26 Unconventional Treatments for Graves’ Disease:
Amy: Yeah, so just in the book the plan, the dietary plan, is very similar for both because when you have a problem in your thyroid, particularly when it’s an autoimmune issue in the thyroid, whether it’s hyper or hypo, the problem really isn’t in the thyroid in itself, it’s in the immune system and in the gut. The fundamentals of the program are the same because where it’s not for the thyroid per say, it’s for the immune system. Then there are different chapters or programs for people with Hashimoto’s versus Graves’ and with Hashimoto’s the main aspect if you do need to be on supplemental thyroid hormone is making sure you’re getting the right labs, they’re being interpreted properly and then you’re getting on the right dose and also the right type of supplemental thyroid hormone.
I go over all of that, the ingredients, the types, what do they mean, what labs do you want, what’s the optimal range. Then those with Graves’ disease the reference ranges are a little … I don’t want to say they don’t matter, but it’s typically when you’re with Graves’ you’re outside these reference ranges or at the higher level of them. Actually, I want to back up. One thing that I didn’t talk about is just really listening to the patient and their symptoms. One of the biggest failures of conventional medicine is not really listening. They just look at the lab test and treat the labs. In functional medicine and in my clinic I’m treating the person. If their labs look beautiful, but they’re telling me that they feel hyper we might be lowering their supplemental thyroid dose. If their labs look beautiful and they feel terrible we might be upping that, so that’s really of big
Then with the Graves’ disease there is as I mentioned … There are some supplemental herbs like motherwort, bugleweed, that can help out better ways to … that are natural beta blockers, natural anti-anxiety medicines and then some that actually block the conversion of T4 to T3. I do talk about some other nonconventional things that I try. After somebody’s done the program if they’re still needing some additional help, a low dose of naltrexone is one which is … I was an ER doctor before I was a functional medicine doctor and naltrexone is what you give to somebody in a high dose, 50 milligrams, somebody who’s overdosed on heroine or opiates and it blocks those receptors and it wakes the person up. We might have saved Prince’s life had somebody gotten to him with a shot of naltrexone.
What they figured out, an extremely low dose is just 1 milligram up to 4.5 milligrams. What happens is it blocks these receptors in the middle of the night and many people with autoimmunity, even cancer, have very low endorphins and so it blocks these receptors at night. Then the body gets flooded with these endorphins and that’s supposed to boost or modulate the immune system, so that’s the theory behind that. Something I don’t think I really wrote in this book, but I’m trying out myself this week is also Helminth therapy, or as Sydney Baker calls it, the little dudes, which are parasites.
25:46 Reasons for Autoimmunity:
There’s a theory in functional medicine that really one of the reasons for autoimmunity in general is the fact that we’re too clean of a society. Back in the day when we were living on dirt floors and not washing our hands as much and didn’t have antibacterial
soap and Purell everywhere that we had a lot more parasites living in us. That these parasites were there really creating this balance in our immune system that were giving us tolerance to ourselves and to the world. It’s one of the theories behind the lower rates of autoimmunity in developing countries. I don’t think it’s quite as simple as that. I think that when a country gets developed their diet changes, there’s more industrialization and more toxins. There’s more stress. Everybody has a cell phone now, being connected to the world. I don’t think it’s singular, as most things are not in the world, but it may be really a missing piece.
I had mentioned my toxic mold exposure and slipping back up that spectrum and things have improved as we’ve gotten out of the situation and traveled and stuff, but there are still a few lingering things. I’m always one for trying new stuff and seeing because it’s
something that will enable me to hopefully help my patients. They’re a little bit leery. We’ve been bringing it up in the clinic, wanting to try it with people, and people are leery of swallowing some parasites. There was even a big New York Times article about this. I wouldn’t say it’s becoming mainstream, but mainstream is at least hearing that this is an option out there.
Mike: Yeah, it’s pretty exciting. We caught up with Dr. Moises Velasquez-Manoff. He wrote the book Epidemic of Absence and talked a lot about helmet therapy, so I’m excited to hear your personal experience after you’ve been doing it a little while. Dr. Amy, let’s go back a little bit to the traditional model, how you mention most traditional internists or family practice doctors are not really looking at the free fraction hormones like you mentioned in the book. You just articulated like free T3, free T4 and looking at the auto-antibodies because like you said the treatment is the same. It’s, okay, more Synthroid or less Synthroid.
You share a story in your book about a gal named Vanessa and a friend of mine called
me earlier with a very similar story and I’ll just condense it. Basically, my friend was calling about his wife and said hey, my wife is feeling terrible. She’s seeing a functional medicine practitioner for her hypothyroid and all the doctor did was adjust her dose, he increased her Synthroid and she feels even worse. I was like wait, they didn’t look at free T3, free T4 or reverse T3 like you mentioned in your book and he’s like no, I didn’t even know about those. I think that’s the system that a lot of people are in and that’s why I commend you for writing this book.
Amy: Did they see a functional medicine doctor or a conventional?
Mike: Unfortunately, a functional medicine practitioner.
Amy: Yeah, yeah, okay.
Mike: I’ll put the caveat on there.
Amy: No, no, no, no, I’ll address that because that’s an example that I give in my book, but yeah, is that the whole story or do you want me to …
Mike: Yeah, that was the whole story.
28:44 Working With Your Doctor:
Amy: Okay. Yeah, so I think when people are … Everybody’s not going to have the luxury of being able to fly to Austin and see me or one of my colleagues. Really this book as opposed to The Autoimmune Solution that I thought you didn’t necessarily have to work with your doctor, this was an alternative, too. With this book, The Thyroid Connection, you really do need to work with the doctor if you need supplemental thyroid hormone. That is a prescription. I wanted to write the book to give people the best chance of working with their conventional doctor.
What you have to do when you’re interviewing somebody to try to figure out is this the right place to go is first ask what labs do they do. Are they running a TSH, a free T3, that’s the most important one, free T4, reverse T3, antibodies. That should be the standard on your first visit, all of those. If they’re not keep going, look for somebody else. Then you want to ask them, and you can even pull out the book and see what the reference ranges are, you can even ask what do they use as their reference ranges, what do they consider is ideal? Then you want to ask them … Of course, that’s all in the book and then you want to ask them what type of supplemental thyroid hormone do they use? You might think, okay, when somebody says Armour or Nature-Throid, great, that’s my doctor. Well, I have plenty of people that do just fine on Synthroid.
What I find is that there’s these camps of people that in conventional medicine it’s
Synthroid, Synthroid, Synthroid, maybe Tirosint or Levoxyl. Then in the functional or alternative or integrative it’s Armour, Nature-Throid, Westhroid, Pure and they’re like the other is bad. You don’t want to get in that camp either. I’ve tried every kind. I take Synthroid and Westhroid Pure myself. I need a combo of the two. You don’t want to go to anybody that’s set in one or the other even if one.The more natural one, seems more appealing to you because you might not be somebody who does well on that. You might find that’s in a pre-form T4, T3 concentration and you might find like me I need more T4 than is available in that, so I take some Synthroid.
You might find that you need more T3 or something and so you want somebody who understands all the different forms and isn’t in a particular camp. They are what is the
best thing for you and there is no one right form of supplemental thyroid hormone. They are as different as every individual is and there’s even compounding T4 and T3 that I talk about in the book. I wanted to make this book as accessible to people and then the information in it as accessible as well. I even partnered with a lab company where people can go … I don’t get anything out of it, but that you can go get your labs done if your doctor won’t do it for you. I’ve formulated a multivitamin to go along with it to help get all the nutrients that you need to help your thyroid. I tried to make this as easy as possible knowing that most people are going to have to go out in the conventional world, so you’ll just need to make phone calls.
I see it all the time, just because somebody has labeled themselves as a functional medicine practitioner or an alternative practitioner is a naturopath, it’s like gluten-free, functional medicine has now become a buzzword. It really is. Nobody searched that term when I first opened my practice 8 years ago. Now everybody’s searching that term,
so now everybody’s using that term that maybe hasn’t been fully trained. Even people who have been trained … Now there’s a certification program, but still there’s not really a standard. You have to do some questioning of somebody before you go and ask. I see that all the time where somebody may order a free T3 and a free T4, even a functional medicine practitioner, but they’re still using the classic reference range rather than optimal and I see that frequently all the time.
That was an example in my book of a patient who had come and they finally got to the functional medicine doctor and they checked the free T3. It was 2.5 and they were told it’s totally normal. Well, 2.3 to 4 is normal, but optimal’s around 3.2, so 2.5 is really low in my opinion. With your friend probably classically was happening is that … I see this all the time is that they might look at the TSH or possibly some other numbers and see that they might need more. They just give them Synthroid which is T4, but if they didn’t check a free T3 then they’re not converting to T3.
Sometimes people will get on that Synthroid and feel worse or feel jittery, but yet still tired and that’s because they have a lot of T4, but they’re not adequately converting it to T3. Or they are, but then most of it’s going to reverse T3 which is more like the break and that’s how people can have these symptoms of having normal looking labs or even optimal sometimes, where somebody’s not checking that reverse T3. They might still feel fatigued or have weight gain or have their hair falling out and stuff like that. That’s a pretty classic thing that I see is people just upping the medication or the supplemental thyroid hormone, but not really looking at all the other lab tests.
33:56 Childbirth and Thyroid Dysfunction:
Mike: Those symptoms that you mentioned, the fatigue, the lethargy, the weight gain, the hair falling out, were the exact symptoms that my friend was articulating about his wife who
just had a baby and so it was a really stressful environment and stuff like that.
Amy: Yeah, I’d like to just address that because that’s a real common time. One of the reasons why thyroid often gets missed on people or women right after birth, that is a time because of these fluctuations in hormones. It’s the thought behind why women get autoimmunity and get thyroid dysfunction more frequently than men is because of these hormonal fluctuations. In pregnancy you have this normal level estrogen skyrocket and then overnight go down and that’s where people can develop symptoms.
We talked about the estrogen binding up the thyroid and then maybe it’s unbinding it. Then what doctors do is they brush it off, right, her hair is falling out, she’s tired, and she’s gained some weight. Of course, she just had a baby, she’s anemic from having a baby and she’s sleep-deprived because she has a baby. They just brush it off as you’re a new mom, it’s all in your head, it’s not your thyroid and that is actually a time where it’s probably likely or potentially more likely that it is your thyroid because of these hormonal shifts. It may be temporary, once things balance out with the hormones, or it might be your new normal and that was what stimulated either an immune or just a thyroid dysfunction in you.
Mike: Beautiful information. Dr. Amy, one more final question before we get into … Till we part ways about some more personal questions about you as a person.
Mike:The chicken or the egg, this comes up a lot. I get this question through Facebook a lot where people say I gained weight and then after I was diagnosed with hypothyroidism, so the weight gain seems to be a result of a thyroid dysfunction. We also know that belly fat and body fat in general can cause autoimmunity and leptin affects the thyroid, so what have you found in your clinical practice? Once people get their thyroid functioning normal and look at this from a functional medicine perspective like you recommend are they able to then lose the weight? Is there a bidirectional relationship? Can you talk about what comes first and how to treat that?
36:06 Weight Gain/Weight Loss:
Amy: Yeah, whether you look at it fortune or not fortunate, I get a lot of people who are losing too much weight sometimes on the diet that I have them on. We get probably more questions from people about how can I keep the weight on rather than how do I get the weight off. I’m not going to say it doesn’t happen, but from a clinical standpoint I don’t frequently have to address that too much where people are getting stuck and most people aren’t coming to me for weight loss, more complex autoimmune issues.
To address the “what came first the chicken or the egg”, it depends on the person. Some people it is simply the thyroid and that is really their primary cause for the weight gain.
Once they get on supplemental thyroid hormone the weight easily comes off particularly if they’re, of course, doing a program like my program and they’re eating real, whole foods. They just don’t really have to worry about an optimal weight, it just happens. That’s some of the biggest, positive feedback that we often get, but as you mentioned this idea of being overweight or obese, it’s an inflammatory state. You have belly fat that can act as a hormone in and of itself. People’s estrogens typically rise in that scenario. They’re probably having blood sugar swings and, therefore, having high cortisol as well.
Again all these things are just they’re feeding on one another. The blood sugars are causing the insulin to go out of whack. That’s then causing the estrogen to go out of whack which then causes more weight gain, more inflammation, more binding of the thyroid hormone. It’s just one on top of another and so it’s like peeling back the onion as we talk about in functional medicine. Sometimes it’s not really helpful to think about
what came first, the chicken or the egg, but just to get on the plan and see.
I certainly have people who’ve been borderline thyroid that we’ve tried … their weight stuck or whatever and we tried the supplemental thyroid hormone. I’ve had a few of those people have the opposite reaction and end up gaining weight. Those are usually people that ultimately end up taking back off of the supplemental thyroid hormone, because when you’re having the opposite response to the hormone that’s really telling me that’s not your problem and that something else is your problem and you need to keep digging.
Mike: Wow, that’s really good information. I know you talked a little bit more about the book, but I wanted to bring that out in the podcast because we do get that quite a bit. Dr. Amy, we have three final questions. I know you have just a few minutes before we have to part ways, but …
Mike: … we want to get to know you a little bit better as a person. We know you’re very driven, very successful. You wrote this book just in a short period of time after launching your New York Times bestseller, the first book, The Autoimmune Solution. We know that successful people have a morning routine, some set of rituals, habits, that they do
every single day. What does the first couple hours of your day look like?
39:08 Dr. Myers’ Morning Routine:
Amy: I got asked this question the other day and I’m like if you knew my life right now, moving into 6 different apartments in 8 months and getting back from 3 weeks of vacation and an apartment full of boxes because we’re waiting for another apartment. There’s not really a routine at the exact minute, but when I was going through all of that and trying to keep my sanity of writing the book I joke and say there’s not a routine.
Fortunately, right now I’m in the book promotion mode, so I just get up when I get up which is usually 7:30, 8:00 when the sun’s bright and shiny in my room. I usually do my heart rate variability, just do a baseline check to see how I’ve recovered from the previous day. If it’s a good day then I’m also doing my HeartMath for about 10 minutes and some just deep breathing. Then I brush my teeth, drink tons of water, take my supplemental thyroid hormone and then hop into breakfast which this morning was 2
egg yolks, 2 little pieces of sausage and some spiral zucchini noodles, walked the dog and then hit the day with …
So far it’s been back to back interviews and then it will end with my going to the gym and probably doing a little more work later. If on a good day, doing some more heart rate variability, getting in my sauna, and then as the sun starts to go down I start to put on my amber glasses, which drives my husband insane. We have amber light bulbs around the house and start trying to tuck it in for the night. Of course, there’s lunch and dinner in there as well. I’m not one to skip a meal.
Amber Glasses to Block Blue Light:
Mike: Yeah, the amber glasses are funny, how spouses respond to those.
Amy: My husband … I was doing an interview for my Thyroid Connection Summit that we have October 24th through 31st which is a free event. I think you’ll be an affiliate, so hopefully, you’ll be promoting that. Sarah Ballantyne does a whole talk on sleep and she was telling me how she had invested … I think they’re like 100 and something dollars for these amber glasses, but they were super stylish. She even wears them out to dinner. I was like oh, my God, my husband would die. I’m like maybe if I spend $100. Mine, of course, are $8 on Amazon, so maybe if I up the ante and spent $100 he wouldn’t be so offended by my amber glasses. Maybe he’ll get me some of those for Christmas or something.
Mike: Yeah, I believe they’re called Swannies. We’ve had James Swanwick on the show, I think episode number 118 or so. Yeah, they’re stylish for sure. He lives in LA, so he’s always out taking Instagram photos with those on and at night, so it’s pretty interesting.
Amy: Okay, I’ll put that in as a request for a Christmas gift.
41:49 Dr. Myers’ Favorite Herb/Nutrient:
Mike: There you go, that’s awesome. Since this is the second time you’ve been on the show you know that we ask a question about one herb, nutrient, or botanical that you just couldn’t live without. Since you mentioned glutathione last time we’ll cross that one off the list. Dr. Amy, if you’re stranded on a desert island, vitamin D, Omega-3s and now glutathione are covered, only one thing you can bring, what would that be and why?
Amy: Since we’re talking about The Thyroid Connection I’m going to say the Myers’ way, multi, that is there, again just I formulated a multivitamin. The first book people felt a little overwhelmed with all the supplements and so I tried to put as much as I could in this multi that would be available to support the thyroid and really anybody, so I’m going to say the Myers’ way, multi.
42:30 Dr. Myers’ Elevator Pitch:
Mike: Awesome, we’ll have that link in the show notes at HighIntensityHealth.com/156. Dr. Myers, a final question here. If you were to bump shoulders with the future President of the United States or someone from the World Health Organization, just had one 30-second spiel to tell them, a lifestyle or health tip that they would maybe influence policy around, what would you want them to know and why?
Amy: I would want them to know how bad GMOs are and to help fight … I would want them to stop GMOs, but at the very least label GMOs.
Mike: Fabulous, I love that. Dr. Myers, I know you have a few different websites. You
mentioned The Thyroid Connection Summit. If folks want to check out your work right now around the time that this interview launches where should they go and…
Amy: Everything is Amy Myers MD, so my website’s AmyMyersMD.com and Myers is M-y-e-r-s. Twitter, Facebook, Instagram, I don’t really Snapchat, but anything you can think of that’s available out there, Pinterest, LinkedIn, it’s all Amy Myers MD. I try to make it easy for people.
Mike: Yeah, I love that. Dr. Myers, I really appreciate you coming on the show. Thanks for writing this amazing book right here, The Thyroid Connection. Hope you have an awesome day and I look forward to catching you or sharing our listeners information about your summit coming up as well, so talk with you soon.
Amy: Thanks so much for having me, I really appreciate it.
Mike: Thank you.