Taking Charge of Your Thyroid and Adrenal Health: A Functional Medicine Approach with McCall McPherson

When it comes to thyroid and adrenal health, too often we rely on incomplete lab data and outdated medical paradigms that leave many women feeling unheard and untreated. As a nurse practitioner deeply invested in women’s wellness, I want to share insights from McCall McPherson, PA, founder of Modern Thyroid Clinic and a passionate advocate for nuanced, patient-centered thyroid care. Her functional medicine approach sheds light on common misconceptions, the importance of lab timing, and how thyroid and adrenal health are intimately connected — empowering you to take control of your health journey.

Why You Must Advocate for Yourself Beyond TSH Testing

One of the biggest myths in thyroid care is that a normal TSH means your thyroid is functioning well. In reality, TSH alone is insufficient for diagnosing or managing thyroid conditions. McCall emphasizes that a full thyroid panel is essential, especially if you’re on thyroid medication like levothyroxine (Synthroid). Once on medication, TSH becomes unreliable because the medication heavily influences it.

TSH and free T4 together only explain about 1% of what is happening with free T3 — the active thyroid hormone that governs your metabolism, energy, skin, digestion, and mood. Therefore, free T3 must be checked to get a true picture of thyroid function.

The Critical Role of Timing When Testing Thyroid Labs

When you’re on thyroid medication, especially those containing active T3 hormone such as Armour, NP Thyroid, Cytomel, or compounded blends, the timing of lab draws is crucial. McCall explains that most conventional practice recommends testing before taking your dose (trough), but this misses the peak hormone levels that show how your medication is truly working.

• Peak testing

  is done 2–4 hours after medication intake, depending on the specific medication.

• This approach ensures your T3 levels are at their highest, allowing your clinician to assess whether your dose is safe and effective.

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Without peak testing, patients often appear hypothyroid and get their doses increased unnecessarily, which can lead to dangerously high T3 levels and serious heart risks like atrial fibrillation or stroke.

Dispelling Common Thyroid Misconceptions

McCall highlights several widespread misunderstandings that hold people back from optimal thyroid health:

• TSH is not enough:

  Treatment decisions based solely on TSH are inadequate and can delay necessary care.

• Normal is not optimal:

  You can have debilitating symptoms despite lab values being “normal.” Optimal thyroid function requires narrow, individualized ranges.

• Levothyroxine limitations:

  Most thyroid patients are on T4-only meds, but if your body struggles to convert T4 to active T3, your labs may look good while you feel terrible.

• Fear of T3 meds is outdated:

  The medical community often fears active T3-containing medications due to concerns about heart risks, yet many patients benefit greatly when dosed thoughtfully.

Understanding these nuances can prevent years of suffering and mismanagement.

The Intersection of Thyroid & Adrenal Health: Why Both Matter

Thyroid dysfunction rarely exists in isolation. McCall stresses that adrenal health is equally critical to restoring overall vitality.

Our adrenal glands, which sit atop the kidneys, regulate stress response via cortisol and influence sleep, energy, and mental clarity. In functional medicine, adrenal dysfunction is seen as a spectrum rather than an all-or-nothing failure.

Chronic thyroid issues often cause adrenal overwork, leading to what some call “adrenal fatigue” — a state of exhaustion and imbalance that exacerbates symptoms.

Supporting Your Adrenals: Lifestyle & Supplements

Rest is paramount. McCall advises that you rest your way out of adrenal dysfunction — not push through with overexercise or stress. Other key strategies include:

• Getting adequate, quality sleep

• Listening to salt cravings (adrenals need salt)

• Incorporating meditation and stress reduction

• Avoiding overexercising — only exercise to the point where you feel equally or more energetic afterward

• Using targeted supplements like Orthomolecular’s adrenal support formula, which contains nourishing ingredients and cow adrenal gland extract to give your body what it’s missing

• Ashwagandha is another favorite adaptogen that can support adrenal balance even in thyroid conditions

Appetite, Metabolism, and the Role of Thyroid in Hunger Regulation

Many women with hypothyroidism experience reduced hunger and metabolic hibernation — the body conserves energy by burning less fuel, leading to low appetite and difficulty maintaining muscle mass.

Improving thyroid function often restores metabolism and hunger signals. McCall explains that one of the earliest signs of thyroid improvement is increased hunger, which means your body is finally burning fuel effectively.

She encourages patients to gently retrain their body to eat multiple meals a day, as hunger hormones adapt to your eating habits over time.

Modern Perspectives on GLP-1s and Metabolic Health

McCall is also at the forefront of using microdosed GLP-1 receptor agonists to support metabolic health, reduce inflammation, and improve outcomes beyond weight loss. She cautions against the standard “one-size-fits-all” dosing that often leads to overmedication and side effects like muscle loss and nutrient deficiencies.

Instead, her approach involves:

• Using tiny, tailored doses starting far below the lowest FDA-approved dose

• Gradually adjusting doses based on individual response

• Prioritizing maintenance of appetite to ensure adequate nutrient intake

• Supporting patients to eventually transition off the medication while maintaining metabolic improvements

Research continues to reveal the broad benefits of GLP-1s, including reduced cancer risk, neuroprotection, and cardiovascular risk reduction.

The Need for Nuanced, Individualized Thyroid Care

Traditional endocrinology often remains rigid, relying on outdated lab ranges and restrictive treatment protocols. McCall points out that much of this stems from generational inertia, fear of active thyroid hormones, and a lack of training on how to safely use combination therapies.

She urges patients and clinicians alike to embrace a more nuanced, individualized approach that:

• Looks beyond TSH and free T4 alone

• Incorporates free T3 measurement and understands peak/trough dynamics

• Considers bioidentical and combination thyroid medications when appropriate

• Respects the interplay between thyroid and adrenal health

• Supports lifestyle, nutrition, and stress management as foundational pillars

For more information, watch this youtube video: