I am delighted to connect with Dr. Amie Hornaman today! Dr. Amie, a.k.a The Thyroid-Fixer, is a woman on a mission to optimize thyroid patients around the world and give them their lives back using her proprietary transformational program: The FIX Method. She is also the founder of the Institute for Thyroid and Hormone Optimization.
When she was in her twenties, Dr. Amie did competitive fitness modeling. She had to work extremely hard to get herself in shape to compete in shows. While preparing for one of the shows, she started gaining weight instead of losing, so she went to the doctor. She ended up seeing many different doctors, all of whom misdiagnosed her. She continued searching until she eventually found a functional integrative practitioner who did the right tests, saved her life, became her mentor, and changed the entire trajectory of her career!
In this episode, Dr. Amie and I dive into thyroid health, the role of specific lab testing, and why checking reverse T3 is so important. We discuss molecular mimicry, weight-loss resistance, and why women need to check testosterone. We also talk about the controversy around iodine and discuss low-dose naltrexone, and the use of berberine, chromium, and inositol.
I hope you gain as much from this episode as I did!
IN THIS EPISODE YOU WILL LEARN:
How did Dr. Amie become so passionate about the thyroid?
Some of the tests that traditional healthcare providers are not doing, that Dr. Amie commonly requires for her patients.
It is possible to have an autoimmune thyroid issue and have negative antibodies.
Dr. Amie discusses the role of reverse T3.
Some common clinical reasons individuals tend to struggle with high reverse T3.
Dr. Amie talks about molecular mimicry and explains how gluten can impact the thyroid, exacerbate autoimmune disorders, and cause a leaky gut.
Why some people did not feel any better following a gluten-free diet when the gluten-free diet first came out.
Eating less processed foods is generally the best way to support your physical health and maintain metabolic flexibility.
Some potential causes of weight-loss resistance in women.
For many women, testosterone is the missing link.
Problems with the Women’s Health Initiative Study.
Dr. Amie shares her thoughts on iodine, LDN, and berberine.
Bio:
Dr. Amie Hornaman, a.k.a The Thyroid-Fixer, is a woman on a mission to optimize thyroid patients around the world and give them their lives back using her proprietary transformational program: The FIX Method. She is also the founder of the Institute for Thyroid and Hormone Optimization.
After her own experience of insufferable symptoms, misdiagnoses, and improper treatment, Dr. Amie set out to help others who she KNEW were going through the same set of frustrations and who were on the same medical roller coaster.
She grabs your hand, gives you answers about your health that no one has told you, and gives you the actual tools and personalized treatment to fix you. What makes her program unique is the extra support and accessibility that you can’t find anywhere else. That’s the transformational journey. With a focus on optimizing thyroid and hormone function, and thus optimizing her patients, Dr. Amie looks at you as a unique individual and not JUST a lab value. She examines all factors that tie into thyroid dysfunction and thyroid symptoms and FIXES you to give you your life back.
“T4 to T3 conversion doesn’t always happen on its own without a little bit of T3 in the mix.”
-Dr. Amie Hornaman
Connect with Cynthia Thurlow
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Submit your questions to support@cynthiathurlow.com
Connect with Dr. Amie Hornaman
On her website
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On the Thyroid Fixer Podcast
Transcript:
Cynthia: Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent are to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
Today, I connected with Dr. Amie Hornaman known as The Thyroid Fixer. We dove deep into talking about how she became so passionate about thyroid management, the role of traditional healthcare labs and how they can miss, subtleties to thyroid dysfunction, the role of autoimmunity, molecular mimicry, the role of nutritional choices with thyroid management, several potential causes of weight loss resistance. We also touched on hormonal replacement therapy and how more often than not testosterone can be a missing link if women are really struggling with weight loss resistance, specific problems with Women's Health Initiative study that we've talked about in prior podcasts and I asked her lots of questions about iodine, low-dose naltrexone therapy and berberine as it pertains to thyroid, and blood sugar dysregulation and management. I hope you will enjoy this podcast and find it as invaluable as I did.
Welcome Dr. Amie. I'm so excited. We are connecting to talk about a shared mutual interest in thyroid and thyroid health.
Amie: Thank you. I'm so happy to be here. I love giving this information to any and all who wants to learn.
Cynthia: What got you so passionate about the thyroid? Was it during your training, or was it a family member, or yourself, or someone who was suffering from thyroid issues?
Amie: Pain to purpose.
Cynthia: [laughs]
Amie: You know how most of us in this space, we've all gone through something that then piques our interest and we say hey, "Wait a minute, if I suffered with this, other people are too," right? My story started many years ago. I was in my 20s, and I was doing fitness modeling and competing. You have to die it down and get really teeny-tiny to get on stage. By no means, I do not come from a skinny-mini family either, by the way. I have diabetes in my family, we have obesity in my family, and I'm 5'2". I would always have to work my butt off to get that show ready shape that was necessary to compete. But no worries, I did it multiple times. This one particular show prep, I started gaining weight instead of losing. Now, I'm not a calories in, calories out kind of girl, but let's face it. Biologically, it didn't make sense that the scale was going up. Not if you looked at my diet of fish, chicken, broccoli, and asparagus. I was going to the gym twice a day. It just didn't make sense. I did what we all do. I go to the doctor. I go to the doctor and I say, "Hey, doc, this is what's going on." Actually, I started with my sister. I blame her first because she's a doctor and she's a DO-
Cynthia: [laughs]
Amie: -and she doesn't know the thyroid. I give her a break but I like to blame her. She said, "You're normal. Everything's fine." Then she referred me to another one of her physicians in her practice and they said, I was fine. I went to endocrinologist, they all said, "You are air quote, normal. You're fine. Just eat less and exercise more." I was like, "What the--? How is that even going to be possible?" It's not even possible. I keep going, I keep going, I keep plugging away. Six doctors later, all misdiagnosed me. The seventh doctor touches my throat says, "Swallow." She goes up, "You have a goiter on your thyroid. We're going to run some tests, do an ultrasound, but here's the pill." I leave the doctor's office, I'm like, "Yes, there's a pill. Now, I'm going to lose weight. Now, I'm going to feel better. Yay!" Five months later, nothing. Not one single change.
Now, looking back, I knew she gave me T4 for only. It was not performing all of the tests that we have to do to get that full picture of the thyroid. I do some research. Yeah, I joke around. I think I had my big old gateway computer at the time. I'm doing the Dr. Google thing that we all do. I find this thing called T3 and this test called reverse T3. I take this information to her and she goes, "Yeah, I don't do that.” I wanted to find somebody who does. I kept hearing the name of this functional, integrative practitioner. You hear something three, four times, it's God, the universe, whatever you believe in telling you, just call this person and go." I call him. He's now my mentor, changed my life, saved my life. Totally changed the trajectory of my career, which is why I'm here now. And it gave me my life back, did the right tests, the right supplements, the right nutrition, the right medication. And all of that mattered at the time in order to get my thyroid up and running again, in addition to testing everything else that goes along with thyroid dysfunction. So, that's really how I came into this space. I knew the hell that I went through, there had to be other women, especially going through this same hell.
Cynthia: Well, what's interesting to me and I say this as a traditionally trained allopathic provider is that I saw women every single day in clinic or the hospital that were counting the same situation. They didn't understand why they were gaining weight, they were on thyroid replacement, most of them Synthroid, which for anyone that's listening, that's a synthetic version of T4. If you can't convert inactive to active thyroid hormone from T4 to T3, your body can't use it. This is where I think the traditional allopathic model really misses the opportunity to understand that it's more than just providing T4. Because there are people who do fine on Synthroid or the generic alternative. But there are most who do not, and we have to really be looking at our patients as individuals, and I really commend you for not embracing or going along with the current status quo of, you are of a certain age and I'm not even sure what age this happened. I know you're still very young, but whatever age this was occurring that you have very unsympathetic healthcare professionals who are like, "So what? You gain five or 10 pounds. That's not a big deal. Look at my other patient population. They're all morbidly obese. Why should you be concerned about this?"
And yet, I think weight loss resistance to me is a sign of an imbalance somewhere that we need to determine. It may not be abundantly clear right away. You were alluding to the right task. When you're talking with your patients about baseline labs, what are some of the tests that you commonly want done that the traditional providers are not doing. I think this is a really good way to start our conversation today, because this question comes up so frequently. I always say, "You need a full thyroid panel" and people are like, "What is that?"
Amie: Exactly. Because if you go into your doctor and you say, "Can you give me a full thyroid panel?" And you're not specific with what you want on that panel, you'll get TSH and maybe if you're lucky, you'll get free T4. That to them is a full "thyroid panel." But what I like to see, we have to go deeper. So, "Okay, yes, we know TSH, free T4. Fine, fine, fine. T4 is inactive. Yeah, I like to take a look at it. Sure, I want to see what your pituitary is doing by testing that TSH, then we have to go deeper." T3 is the active thyroid hormone. That we need to know how much free unbound T3 active thyroid hormone is in your body. Because that's what's getting into the cell. That's what's giving you a metabolism, and growing your hair, and allowing you to go to the bathroom every day, and making you feel good, and giving you energy to get through your day. We need to know what that free T3 level is. That is imperative.
Then we also want to know what your reverse T3 is. Now, we'll dive into a little bit more about what reverse T3 is. But in a nutshell, it's the anti-thyroid hormone. Free T3 is the gas, reverse T3 brakes. We want to know both of those numbers. Then I want to know how many antibodies you have. If you have Hashimoto's, TPO, thyroid peroxidase, and TG antibody, thyroglobulin antibody, we want both of those two. It's amazing, Cynthia. How many doctors think you only have one--? We're just going to test one antibody and call it a-- No, let's test two of them. Let's test them both because there are two to see if this person has Hashimoto's or not. To see if it's an autoimmune condition, to see if we have to pay attention to the destruction of the thyroid gland. And then how much we have to really crack the whip on going gluten free because if there are Hashimoto antibodies, then we have to help that person along to be gluten free because of molecular mimicry, which we can get into as well.
Cynthia: Well, I think it's really important for everyone to understand that you can have an autoimmune thyroid issue and have negative antibodies. I say this with love because I was one of those people. I've been gluten free for over 10 years and I reversed another autoimmune condition. And if you have one, you're more prone to more than one. And so, I had psoriasis, after being treated for Lyme, very common. Cleared that with going gluten free, developed hypothyroidism in my early 40s and I never will forget my doctor saying to me, "Congratulations, you don't have Hashimoto's." I was like, "Oh." I'm one of those odd very small percentage of people that has non-autoimmune hypothyroidism. Well, I've come to find out that actually isn't correct.
Amie: Right.
Cynthia: My antibodies are probably negative, because I don't eat gluten. If you're out there and you have hypothyroidism, you can assume you have Hashimoto's until proven otherwise. That is the bulk of people that have an underactive thyroid. I just wanted to shove that in there, because I, for many years, I was like, "This is awesome. I don't have Hashimoto's. Yeah, I do. I actually do. It's in remission."
Amie: Yep.
Cynthia: But nonetheless, super important. When we're talking about reverse T3, because this is a really poorly understood lab. It's an easy one to draw, it is covered by your insurance, it is not a weird integrative medicine test.
Amie: Right.
Cynthia: Let's talk a little bit about this. Maybe for the benefit of listeners, who maybe are not as familiar as with these terms, T4 and T3, most of our thyroid hormone is in the form of T4, a very small percentage of it is in T3. T3 is the gas tank. That is what actually is the active thyroid hormone. And so, the role of reverse T3 is--
Amie: Yes. Let's break this down. The role of reverse T3, we want reverse T3 because if you go into the hospital, you're in a car accident, your appendix just burst, whatever traumatic state that your body is in, and you land in the ER, you land in the ICU, that reverse T3 is going up, because it's going to protect you. It is built in our bodies to slow down all of those systems that don't really have to be operating when you need to survive. When your body is in survival mode, you don't need to burn fat, you don't need to grow your hair, you don't need to feel good. That reverse T3 will go up in order to shut those other systems down, so that everything that your body needs to heal and survive is there for you. It's great. But here's the thing. We don't want reverse T3 high when you're running around all day, taking the kids to school, and going to the grocery store, and running a business, and being a mom, and being a wife, and being an entrepreneur, and going to work. No, that's the last time we want you with a high reverse T3. So, it absolutely needs to be tested.
I love using analogy, so your listeners can understand. Here's another one to think of. Even if you are taking thyroid hormone replacement therapy and hopefully, you are not on T4 only, because Cynthia said earlier on and I 100% agree, T4 to T3 conversion doesn't always happen on its own without a little bit of T3 in the mix. We have to check all of those things that can come into play and hinder T4 to T3 conversion and raise reverse T3, and the list is long. Most of us don't convert. We want to make sure that even if you are on thyroid medication, you're converting that. Even if you are on something that contains T3, we want to make sure it's getting into the cell. Reverse T3 is like a bouncer at the club, sitting outside your cell door. Now, think about this. Every cell in your body has a receptor site on it for T3, the active thyroid hormone. Every cell, your brain, your heart, every single cell. If reverse T3 is high, it's like the bouncer with his arms crossed outside the club going, "Yeah, T3, you're not getting in and you're not getting in either." It's literally blocking T3 from getting to its receptor site that it so desperately wants.
Even if we're testing your free T3 to see how much of that active thyroid hormone is in your body, it can look really pretty on paper. If we don't know your reverse T3, your doctor could easily say, "Well, look, hey, your TSH is good, free T4 is good, free T3 is good, you're good." And you're like, "Wait a minute, no, I'm gaining weight, I'm tired all the time, my hair's falling out." If no one tests that reverse T3, you could literally be walking around in survival mode and all of that T3 in your system cannot get into the cell to do its job.
Cynthia: What are the most common reasons that you see clinically for individuals that are struggling with high reverse T3? I have a couple that I've seen in clinical practice. I think with our increasingly metabolically inflexible population, insulin resistance plays a huge role. But what are some of the other more common things that you are seeing in clinical practice?
Amie: I totally agree with you in some resistances. Number one, I had one patient I have to tell you about her reverse T3-- Young girl, too, young. Reverse T3 was so high. It was actually flag high. Of course, we have functional optimal ranges and then we have that standard lab value range that you see on your labs. Her reverse T3 was actually flag high at a 35 or 37. Her insulin was a 57. I have never seen an insulin level that high. That was absolutely why her reverse T3 was elevated. 100%. Now, we also see estrogen dominance as a reason, low iron, anemia, low ferritin, low magnesium, low iodine, just a low nutrient status. There are genetic snips that can interfere with T4 to T3 conversion. The list is long and that's why I get so confused and so irritated when patients will come to me, and just like you said earlier, Cynthia, this is not a wackadoodle new age functional test that we're asking for. This is a standard test that should be part of every thyroid panel and I have so many patients come to me saying, "Well, I asked my doctor and they said, it's only useful in clinical purposes." Meaning, if you're lying trying to survive in the ICU or the ER, yeah, of course, we want to test that. But again, like I said I want to know what is your reverse T3 when you're walking around.
Cynthia: No, it makes complete sense. On a lot of levels, I've seen it high with stress. How many people over the past two years haven't had more stress than they normally are dealing with. I also see it in that very type A woman, who thinks if a little bit of exercise is good, too much exercise is better, just like fasting. If a little bit of fasting is good, too much fasting is better. And so that particular personality, the people that want to do Orangetheory fitness five days a week with no recovery, and they restrict their carbs, and they measure everything, they're very controlling in terms of how they look at their lifestyle choices. I always say, I applaud you for being so diligent, however. That amount of stress, and overexercising, and what is creating inflammation, and oxidative stress is not helping your body. If you're listening to this and you fall into one of those buckets, there's no judgment. But we have to be kind to ourselves. If the last two years have taught us nothing, we need to be kind to ourselves, we need to get out in nature more, we need to do a little less exercise. I'm all for exercise, but let's be smart with our time.
Amie: Right.
Cynthia: Now, I want to make sure that we pivot just a little bit to talk about a term that we've already identified, molecular mimicry. The reason why I mention this is, I am asked, I have a monthly group, every month I have someone that asked a question about this. Because they really want to be told that, "It's okay to eat gluten if they have an autoimmune issue with their thyroid." And so, I talked around the physiology, and talked about dairy, and talked about gluten. But let's talk about what these actually do to our thyroid, how they impact leaky gut, how they can exacerbate our autoimmune disorder when we continue to eat these foods, which maybe if you don't have an autoimmune issue are probably, potentially okay. I just say, potentially, because it's oftentimes what's done to gluten, what's done to grains that creates a lot of these health issues. But I would love for you to get your insights on what this is doing in the body, so that someone else can explain it to my community and do it in a way that makes it a little more tangible.
Amie: Right. Okay. So, another analogy coming at you here. I always talk about any autoimmune condition. But we'll focus on Hashimoto's, today. Any autoimmune condition, you have a group of soldiers in your body. Those are the antibodies. Those are the TPO and TG antibody that I want you to have tested. That's going to tell us how many soldiers you have that are-- They're just confused, they think your thyroid gland is an invader, they think it's a bad guy. These soldiers go out and they attack your thyroid because they think, "Ooh, bad guy. We need to attack. We need to start a war." Now, when you go gluten free, those soldiers like-- You experience and I experience the same thing. Those soldiers can go down to zero, which is where we want them. We don't want you to have soldiers in your body. You might always have that genetic predisposition for autoimmune, but we ultimately want to get those soldiers down to zero. So, they're not going out. When you are gluten free, that is what allows those antibodies to continue dropping down.
Now, gluten. This is fascinating, actually, when you think about it. Gluten has a molecular structure, very similar to your thyroid gland. When you consume gluten and you have Hashimoto's, your soldiers are prime for attack. They see that gluten coming in, they're like, "Guys, it's war. We got to go out, we got to attack this." They go out and they start destroying that gluten molecule that very much looks like the thyroid gland, and then they move over to your thyroid gland, and destroy it more. Now, if you're sitting there saying, "Well, wait, I don't have a thyroid gland. I had a total thyroidectomy, I had radioactive iodine." Okay, they're going to go somewhere else. They're going to move to your joints, and you're going to get RA, they're going to move to your gut, you're going to get Crohn's, maybe celiac, you don't want that. You want your soldiers contained in their barracks and you want them to basically go down to zero.
The other thing that occurs whenever we expose ourselves to gluten, you're building your army. Now, those 10 soldiers might go to a hundred, might go to a thousand. Now, you have more destruction. More destruction happening to your thyroid. As your thyroid gland is destroyed, it's not going to work very well. Just like when you're sick and you have to stay home from work, you're not doing much work that day. You are laying in your bed, right? A beat-up thyroid gland is not going to produce thyroid hormones that you need to feel good, to lose that, to have your brain function. It's not going to work very well. We don't want it beat up on a daily basis. You wouldn't like that. If somebody came your house and beat you up, we don't want your thyroid gland beat up on a daily basis. That's why it's so, so important. I think if you can picture that analogy and if you can think about it that way, that we have scientific proof that a gluten or gliadin protein molecule looks like the thyroid gland. You think about that every time you eat gluten. Every time you go, "Well, you know what a little bit won't hurt." Well, my friend, Susie, next door, she's gluten all the time. She doesn't have any problems. If you think about you and your particular autoimmune condition, if you have Hashimoto's, and you're eating gluten, you are slowly or you are quickly destroying your thyroid gland every single time. So, that should give you a little motivation to go gluten free.
Cynthia: Why do you think this is so poorly understood? Why do you think there aren't more of us talking to our patients about this?
Amie: Ah, that's a really good question. I want to say because and I've said this forever. I think the gluten-free diet, whenever it came out had its heyday. Maybe I don't know, seven, 10 years ago, maybe even longer. But it got a bad rap because people would implement "gluten free," but they would go out and buy everything in the grocery store labeled gluten free. "Okay, well, I'm going to replace my cereal with gluten-free cereal, my bread with gluten-free bread, and my pasta gluten-free pasta, my cookies with gluten-free cookies." And they're still taking in high amounts of carbs and sugar, and inflammatory ingredients that are still as you mentioned earlier destroying your gut, producing leaky gut. So, going to the gut, let me sidestep there. We used to and I'm sure you've had guests on talking about this, but I'll talk about it as well. We used to think that the gut from your mouth to your bum was a totally enclosed system. Tile and grout, tile and grout, totally enclosed. Now, we know that that grout isn't so solid. It's like a little swinging door. When we eat things that like pesticides, gluten, high-inflammatory foods that can open the door and these we call them in the functional world, LPS, lipopolysaccharides, they can get into the bloodstream and cause inflammation.
Now, that doesn't mean that they're going to get in your bloodstream, you're going to have a sore knee or a tennis elbow. It can create this full body inflammation. Meaning, it can inflame your thyroid. It can shut down production of thyroid hormone, or it can cause a migraine, or it can cause you to gain weight, it can cause a multitude of symptoms. But we know that these particular food groups cause that. When people, years ago went gluten free, they all said, "Well, I don't feel any better. I didn't lose weight. My inflammation didn't go down." It was because you weren't replacing it with real whole food. You were replacing it with the gluten-free manufactured version, which still jacked her insulin up, which still created an inflammation, which still cause leaky gut. You didn't even get the benefits of a true whole food, real food, gluten-free diet. That's where I think it got almost brushed aside is like, "Oh, that's another one of those new age fads that are coming out. It's the next diet thing." Well, no, it's not.
We have scientific proof. If you do it the right way, you can actually experience the benefits that should have been experienced years ago when it first came out. But nobody really told people, "Listen, don't just go to the grocery store and purchase everything labeled gluten free. That's not what you want to do." No one guided anybody back then. But now, we know. So, I think our job as practitioners is to talk about it more, is to educate the population, so that they can understand the why. I think when you understand the why, when you know why you're doing something, when you know why you're giving up something that maybe is really hard to do, it sticks more. You have that motivation, you have that reason, you have that carrot dangling like, "Okay, I'm going to feel better, and I'm going to lose weight, and that's why I'm doing what I'm doing. That's why I'm eliminating gluten."
Cynthia: Well, I think it's a really good point and certainly, a very important one to that as we are transitioning to a more nutrient dense diet that we are conscientious about the food choices we're making, and I'm always very transparent, and I tell everyone, "I don't buy gluten-free bread, I don't buy gluten-free cookies, I don't buy any of that stuff," because I am the type of person that if I eat one ant I'll eat several and I do better having a piece of dark chocolate because then my brain goes, "Okay, we're satisfied. We move away." But flour, gluten-free flour, regular flour, etc., it is still like mainstreaming cocaine. Because it gets instantaneously into your bloodstream, it lights up our brains, we get this dopamine surge, we feel good. One of the challenges I always have and I'm sure you probably do as well is that when I encourage people to go lower carb, they're like, "Oh, I can have the almond flour, this, and the almond flour that." Well, yes, that's lower carb. However, we're still not getting away from these highly processed flours. Part of the challenge in our world where whether it's keto, whether it's low carb, whether it's paleo, primal, etc., it's all this highly processed hyper palatable food. I don't care how you label it.
I was just at a keto event with a bunch of wonderful individuals. One of the sponsors, who will remain nameless, my husband was with me, and he was trying some of their products, and I'm dairy free, so, a lot of what they had was not a good choice for me. I happen to flip over one of the packages of stuff that they had and one of the sweeteners was sucralose. As an example, here we are, artificial sugars. But if someone's coming from eating like Ho Hos, and Ding Dongs, and Twinkies, this is healthier, but those artificial sugars, we know they disrupt the gut microbiome. You were just talking about that. And so, I think it's just this building awareness of, "Okay, if you really want bread, you shouldn't be doing it often and you really should try to find something that's less processed, or make it from home, or make zoodles instead of pasta." Just find healthier options, I mean, we're both realists. But I think it's the hard truth is you just need to eat less processed food. That's really the best way to support not just your thyroid, but your physiology in general.
Most if not all, women that are listening to this podcast are north of 35. All of a sudden, our carbohydrate intake has to change. It doesn't mean no carbs, it just means you can eat endless amounts of pasta, and rice, and bread, and think that you're going to maintain metabolic flexibility. This is a great segue to talking about weight loss resistance. A lot of the hormones we've touched on like insulin, and leptin, and thyroid hormone, and obviously, as someone that used to do bodybuilding, I can imagine that when you got into this position where all of a sudden you were gaining weight, not losing weight, knowing that you had a methodology that was working effectively when we're looking at women north of 35, perimenopause, menopause, this is a huge problem and it's a source of frustration. I'm endlessly supportive and loving in my approach because I know how frustrating it can be. Even more, so, for people who've never struggled with their weight, they're like, "What am I doing wrong?" That's how I came to intermittent fasting, because I was like, "Something is not working. I need to try a different strategy." So, when we're talking about weight loss resistance, when you're working with your patients, what are some of the things you're thinking about that they might be doing that are making this harder for them to lose weight?
Amie: If we start at the top with the master gland, thyroid, we have to optimize that first, downstream from that, like you mentioned is insulin. 99% of hypothyroid Hashimoto patients have insulin resistance. That has to be addressed. It has to be. And I always talk about "it's not fair syndrome," because we go through this. Even if you aren't north of 35 or you were just diagnosed with a thyroid condition, you go through this, it's not fair stage. Like I mentioned, Susie, your neighbor earlier, you look at Susie, and you go, "Wait a minute, why can she eat her gluten-free bread, and her fruit all day long, and throw in some whey protein? Why can she eat that way, but I can't?" Well, it's called insulin resistance and a thyroid problem. That's the double whammy to weight loss resistance. Thyroid problem, insulin resistance. The triple whammy is low testosterone with that. Testosterone, I call it the GSD hormone. Get stuff done hormone.
Cynthia: [laughs]
Amie: You need it to get stuff done. Motivation, sex drive, fat burning, muscle building, brain function, and again, that is a test. It's a lab value that is lost in conventional medicine. Because there definitely is an optimal range. As women, we get stuck into this standard lab value range that is huge, wide, vast. If you fall in the lower part, but you're still in that range, and you're not flagged, and that lab value isn't red, and you don't have an H or an L next to it, you are forgotten, you're dismissed, you're told you're normal, everything is fine. In conventional medicine, you could have a testosterone of a 3as a woman and still be called normal, because the cutoff is 2. Do you know how you're going to feel with a testosterone level of a 3? You're not going to burn fat at all. Weight loss resistance out the wazoo. Low testosterone actually triggers Hashimoto. That is one of many things that can flip that autoimmune switch for Hashimoto's. Any kind of stressor like pregnancy, perimenopause, hormonal changes, low testosterone will flip on that Hashimoto switch.
Now, you're entering that triple whammy zone of weight loss resistance with low testosterone as well. Optimal in my book, over 50. Again, and this is total. There's total and free testosterone that we can check on you. But when you're looking at the total, I want that number over 50. And again, you could be called normal if you come in at a 3, at a 5, at a 10. That's not normal. That's not enough testosterone. Testosterone is also almost villainized with women because you do have the bodybuilding circuit that's abusing it. When you tell an average soccer mom, 45-year-old woman, "Hey, your testosterone is in the tank." We need to do some bioidentical hormone replacement. I don't want to look like a dude. You have no testosterone. That person over there that's abusing it has male levels of testosterone. Let's find a happy medium for you. You can get stuff done. So, you can feel like a badass rockstar like you're meant to feel. Testosterone is that third component, whenever we're talking about weight loss resistance.
Cynthia: I love that you brought it up because not only is it not talked about a lot and I did a great podcast talking about testosterone replacement therapy with Dr. Kyrin Dunston last year, because for many, many women it is the missing link. And unfortunately, it's a controlled substance. Obviously, you have to have it prescribed. I find most women do better on creams than they do on injectables. But obviously, it's different and unique for each woman. My own practitioner was saying, "I don't like to use injectables, even if it's subcutaneous all that often because it can be a little less predictable." And he said, "Sometimes, women will have these overt insane libido drives," which maybe their partner's happy, but they get to a point where like, "I understand what it must be to be a younger person, because all I'm doing is thinking about this one activity and I can't get work done." But for those of us that have experienced low testosterone, I can tell you, you feel unmotivated, you struggled to put muscle mass on, even muscle definition, your libido goes in the toilet.
I hear from a lot of women and I've experienced this myself until it was replaced. I remember thinking, it was a whole different world. It's not just the superficiality of seeing its muscles, the organ of longevity, it's obviously critically important. Our libidos are important, our motivation is important, but it's also understanding that the brain physiology. It is not just testosterone, it's not just estrogen, it's not just progesterone that our bodies need the testosterone signaling in our brains, with our bones, with our muscles. We, sometimes, lose sight of this. I think the Women's Health Initiative that it came out in 2002 has really done us a disservice. Us, as women, obviously your mother's generation, my mother's generation really suffered through this and we can see a lot of the side effects that have come out of that. But our generation is demanding better care. I always say, I'm hopeful that my nieces, I have three of them that they are going to get better care because we are advocating for all women. But it is completely unacceptable for women to suffer when what they really need to consider with the right practitioner is replacement, whether it's with thyroid hormone, whether it's treating the insulin resistance, whether it's addressing the thyroid, excuse me, the testosterone needs estrogen, progesterone, etc., all of us, it's not a stew.
We all have to have different ingredients, because each one of us are bio individuals. But no woman should have to suffer in middle age. That's something that has become abundantly apparent to me having the opportunity as I'm sure you have and talking to different women. I have women in their early 60s, who are smart, and they have suffered for years with brain fog, and poor sleep, and forget about their libido. I just interviewed Dr. Tabatha yesterday, and we were talking about some of the changes that go on in the vagina, and the vulva, and throughout the body, and she was saying, "Too many women I see, who haven't had sex in 10 years, maybe their partner passed away, maybe they lost interest, and they've gotten to a point where they no longer can have sex comfortably." I always say we need to be intervening years, and years, and years before this happens, so that women can make the best decisions for them, and they can find the right provider that's going to be able to support their needs in a way that aligns with their own wants and needs.
Amie: Absolutely. And I'm glad you brought up the Women's Health Initiative study, because I still have even young women, even our generation and younger are still, and I use this term very lovingly and very loosely, brainwashed from what they're-- Because it comes back to their doctor. Their doctor, who educated them that hormones are bad, because we have this study that shows that it causes cancer. Their doctors are stuck in outdated information. And not even so much outdated, but we have to look at what happened in the Women's Health Initiative study. They use synthetic hormones. They did not screen and remove sick women or preexisting conditions. They didn't do any of that. We could dive in for an hour on just the Women's Health Initiative study on its own, but I'm still finding women that are being told misinformation if I can use that term. Misinformation by their PCP, by their general practitioner, or by their OB-GYN. It's the doctor's responsibility to come into 2022 to get educated, to stay educated, to stay updated. It's very, very similar going back to the thyroid. I will still hear practitioners say, "Well, your TSH is suppressed. So, we need to drop your thyroid medication." Meanwhile, these women are still suffering. They're like, "Wait a minute, I don't feel well still. I still haven't lost weight, I still have this brain fog, and you're going to drop my thyroid medication?" Again, it's these doctors that are focused on TSH alone because that is what they learned.