Episode 2: The Gut-Thyroid Connection with Dr. Christine Maren

I think you really have to be your own advocate in this world, but pick a guide who is sort of on your same page and has similar philosophies. I'm Dr. Seth Ozgood, the founder of grassroots functional medicine. After struggling for years with chronic health issues that traditional medicine and pharmaceuticals could not resolve, I finally found relief in true healing with a functional medicine approach. Since then, I've dedicated my life to helping patients around the world transform their health by getting to the root cause of symptoms and restoring their body's natural ability to heal. This experience has shown me that a true state of wellness often requires an integrated approach that brings in multiple disciplines and modalities. In this podcast, I will interview experts across the wellness spectrum to educate and empower you on the tools available to reclaim your health. If you're struggling with health challenges and you're not getting the answers or the results you feel you deserve or you simply want to optimize your health and take a proactive approach to wellness, this podcast is for you. And if you like the show and find it helpful, please be sure to tell a friend, subscribe, rate, and review wherever you listen to podcasts. Let's get started. Dr. Kristine Marin is a board certified physician in the founder of a virtual functional medicine practice in Colorado, Michigan, and Texas. She is the co-founder of Hey Mommy, a platform dedicated to helping women navigate a healthy and happy motherhood. Dr. Marin was introduced to functional medicine after struggling with pregnancy complications and reoccurrent miscarriages. A functional medicine approach helped her to address her own underlying health issues associated with gut infections, hypothyroidism, hormone balances, and mold toxicity. Now, a mother of three, she's devoted her professional life to helping women optimize their health before pregnancy, thrive, postpartum, and get their lives back. Dr. Marin is board certified by the American Board of Family Medicine and an institute for functional medicine certified practitioner. She is a compassionate clinician, speaker, and wellness advocate. Let's dive in and get started. Well, hi, Kristine. Welcome to the Grassroots Functional Medicine podcast. Thank you so much for joining me today. I've been looking forward to this conversation. Me too. We have so much to catch up on. Awesome. Well, today's topic, for those of you who are listening, is going to be the thyroid gut connection. I'm really excited about this topic because I think it's going to help a lot of people. But before we jump into today's topic, do you mind sharing a little bit about your story and really what got you interested into functional medicine? Yeah. So, I mean, it's a long story, but to keep it brief, it all really revolved around pregnancy complications. I was always really sort of driven toward functional medicine and more, I should say more holistic kind of treatments. Anyways, just I grew up in Boulder, while I grew up in Golden, went to a college in Boulder and had some success with that early on. Just with kind of hormone imbalance and acupuncturist and nutrition was really helpful for me. I went to osteopathic medical school, some at DO, and I did that intentionally because it was just kind of, I was hoping was going to give me sort of a more holistic training. But fast forward to pregnancies, I had my first child at the end of my residency training in family medicine, and I had gestational diabetes. And it was super weird because I had like zero traditional risk factors. And I really wanted to understand why. That was sort of when I did a deep dive into nutrition. And eventually sort of figured out that gluten was not great for me. I think there was just a lot of inflammation going on at that time. But my second child, I had a lot of complications between those two. And I had trouble getting pregnant and when I got pregnant, I had miscarriages. And I just knew there was something going on with my body, particularly my gut, was like the big kind of tattletail. And then also had thyroid issues at that time. And I eventually kind of uncovered that and had a successful second and third pregnancy. But that whole journey just really opened my eyes to functional medicine and that's sort of when my professional and personal life's collided. Because I saw it out for myself and knew at that point, there was really no other answer for me in terms of practicing medicine. I actually, I kind of referred every patient I saw. I was like, oh, when that every patient. But those two who needed it, I'm like, you need to see a functional medicine doctor. And my sister-in-law and all these other people, I need to be a functional medicine doctor, really. So. It's so funny. That's such a great story. And it's so true. We hear that now too as practitioners that we're getting referrals from other traditional doctors saying, hey, we're not quite sure what to do with you. You need to go see a functional medicine practitioner. Yeah. Yeah. For that a lot. Yeah, I love those referrals. And I always think, you know, it's great when people have obviously gone through the conventional workup, rolled out red flags, but there's just not always an answer for some people's issues. I mean, there's not always time to really go through somebody's history. So. It's so true. So true. So on that note with the thyroid and the gut, before we jump into that connection, do you mind explaining to people who are not familiar with thyroid health? Maybe what is the thyroid gland and why is it so important? Yeah. So the thyroid gland really sits at the base of your neck. It's an endocrine organ that produces thyroid hormone and thyroid hormone really interacts in like every cell of your body. So really controls metabolism. So we think about thyroid in terms of fatigue and weight a lot of times. People with low thyroid function tend to have weight loss resistance or they gain weight unexplained, tend to feel tired, sometimes depression, anxiety kind of mood symptoms come into play. Often people feel kind of cold or have a really hard time warming up. I've been there. It's like you're cold to the bone and shivering and everybody else is like in a t-shirt. So it's just kind of this your body temperature, your metabolism, everything goes down, but also really is important in terms of gut metabolism. And I think that's something that is not always talked about. Absolutely. Absolutely. Yeah, we really like you said it has it's has fingers in every almost every cell in the body and that's where all that broad list of symptoms comes from that you mentioned because unfortunately, you know, that you could have things that get thrown off as digestive problems or hormonal imbalances when in fact the thyroid is at the core. What would you say the difference is, you know, when a lot of people are struggling with these symptoms and they're not getting a lot of help, can you explain a little bit about what the conventional approach to thyroid may look like versus what the functional approach may look like? Yeah, and I know it well because I was trained, you know, that way. So in conventional medicine, we're sort of trained. If TSH goes really high, TSH is really a regulatory hormone from the brain that signals your thyroid gland to produce hormone. The traditional measurement, if you go see a family medicine doctor, is usually to check a TSH. Sometimes they'll order it as a TSH with reflex to free T4. Free T4 is really a measurement of your thyroid hormone, whereas again, TSH is that regulatory hormone. And if those numbers are off, then you might be diagnosed with hypothyroidism, but they have to be pretty darn off. So it's really kind of like a spectrum. And if you're at, you know, the far end of the spectrum and your TSH is over 10, maybe over 5, you'll get diagnosed with hypothyroidism. There's also subclinical hypothyroidism when your TSH is a little bit high, but your T4 isn't a normal range. So when they reflexively check that free T4, you're in a normal range. So those normal ranges, there's a lot of debate. So for many years, many people have been debating that the high end of what's considered normal on the reference range for TSH ought to be lower. So instead of calling people hypothyroid when their TSH is 5, maybe it should be when their TSH is 3. So kind of 2.5 has been the debatable upper limit of that reference range, but it hasn't changed. It still is, you know, around 4.5 depending on the lab that you use. And so you have to be really hypothyroid to get that diagnosis. In functional medicine, we kind of look at more sort of optimal reference ranges. I'd consider treatment not always, but I would consider treatment for somebody who has a TSH over 2.5 and a T4 or a T3 in the low end of the reference range. And with T3, in particular, the reference range is really huge. It goes from like 2.1 up to 4.2 in most labs. I like to see it in the three. So 3.2 to 3.8 is kind of like that magic spot that doesn't mean everybody with a TSH or a free T3 of 2.9 is getting treated with thyroid hormone, but I'm certainly looking at thyroid function and how can we improve that naturally and/or union medication? For instance, if you go and see your doctor and your TSH is 3.9 and your free T4 is 0.9, you're not going to get treated. If you see a functional medicine doctor with those numbers and have symptoms, you might get treated. So it just depends sort of on symptoms. It depends on sort of where you're at. I think the other big huge piece of that is thyroid antibodies. So Hashimoto's is the most common cause of hypothyroidism, but really Hashimoto's is an immune system disorder. So it's an autoimmune disorder where our body essentially attacks thyroid tissue. So many times those numbers are either not checked or just kind of ignored. Again, just going back to my conventional training, it was like, "Well, your hypothyroid, that's the end of the story." We weren't really looking to see if some de-actually had Hashimoto's, but as you and I both really know, when there is an autoimmune component we're treating that separately and differently. Absolutely, I think that's so important. So you mentioned Indeed. T3, T4. Do you mind explaining a little bit about what the difference is between those two hormones? Yeah. So TSH is sort of that top level, stimulates the thyroid to make T4 mostly, and then T4 gets converted to T3 mostly in the peripheral tissues. So T3 is not, there is a little bit produced by the thyroid, but mostly it's just converted from T4. And so sometimes people will have a low T3, but a normal T4. And I generally think of that as not actually a problem with the thyroid. It's like a problem outside of a thyroid that has to do with inflammation, toxins, infections, not enough calories in your diet, that sort of thing. Sometimes we see that people will make basically divert a bunch of their resources, so make a lot of reverse T3, and not enough free T3, and that will explain some thyroid symptoms, but it's not always the thyroid's fault with low T3. Absolutely. And I think that's where the functional medicine approach is so important, because unfortunately what we see a lot of times in the conventional world is that it just gets left alone, they get put on the T4 medication, and if they have a problem with conversion, that's not going to always do what they want it to do, or it just gets ignored completely. And we need to be exploring, as opposed to just replacing the hormone, we need exploring why is the body not converting that inactive to the active hormone. And that's where you mentioned, you know, the nutrition, the gut health, the stress, the hormones, all of those things in more can play a big role in that. That's awesome. So, now, to jump into that whole concept of digestion and the connection between the gut, what are some of the symptoms that people may experience from a digestive standpoint, if their thyroid isn't up to par and where it needs to be? So traditionally we think of constipation, so people with hypothyroidism often are constipated, but a big one is just IBS. So you know how many people have IBS? If you have IBS, look at your thyroid, because your thyroid might have a big part of that. IBS, as you and I know, is almost much of the time it's caused by bacterial overgrowth. There's SIBO, a small intestine bacterial overgrowth, and you know, there's one study, one 2007 study that looked at patients who have Hashimoto's disease, only over 50% of them also have SIBO, so small intestine bacterial overgrowth. So there's a huge overlap there, and I think it makes sense once we understand how the thyroid sort of signals are gut, and then of course that kind of vicious cycle with a gut, then signals are thyroid or supports thyroid function, but yeah, I mean, I think a big one is just sort of there's intestinal motor dysfunction that happens, so it might have a constipation, you might just have like IBS symptoms and lose stools and bloating and stuff like that, but either way, I think if you have digestive symptoms, you ought to look really closely at the thyroid. Absolutely, and I think that's like you said, it's so important to think about when you have digestive symptoms, we have to figure out why, and a lot of people get that blanket diagnosis of IBS, which essentially just means that something screwed up in the gut, we don't know what it is. Try these medications, let's see what happens. Your vowels are irritated. Exactly. So the next logical question of mine, my review would be why is it irritated, and the thyroid plays a huge role with that in regulating HCL or stomach acid production. Like you said, the constipation, gall bladder function, there's so many different things that come into play there, and I wanted to come back, circle back around. One of the things that you mentioned was the fact that autoimmunity is one of the leading culprits of thyroid dysfunction for Hashimoto's or Graves disease. Can you explain a little bit about why it's so important for patients with autoimmunity to work on correcting their digestive tract, and maybe some of the mechanisms of gut dysfunction that may actually contribute to autoimmunity in the first place? Yeah, it's such an important connection. So most of this literature is based on studies from a lesio-fasano, but there's this triad with autoimmunity. So number one is a genetic predisposition. Number two is an environmental trigger. And number three is intestinal hyperpermuntility. And often intestinal hyperpermuntility is called leaky gut, but essentially it just has to do with our immune system sort of getting triggered because the tube that goes from top to bottom should be like a hose. It should be intact. And when it starts to get kind of leaky, things leak through or immune system starts to see it, it can lead to autoimmunity and presposed individuals. So yeah, gut infections are a big trigger for that intestinal permeability. I mean, a lot of times people kind of start down the track of like elimination diets and taking foods out, which gluten is the big culprit there. Two things that will cause an increase in a protein called zonulin, zonulin being the thing that causes leaky gut. And we know that that's gluten and smontestin vector overgrowth. There are probably other things like fungal overgrowth and other sorts of gut infections and other kinds of foods. But really when it comes to sort of addressing the gut health issues, it's like number one and two is removed and replaced. And what that means is remove some of the offending foods, especially gluten, remove the infection, vector overgrowth, parasites, candida or fungal overgrowth, whatever it might be, and then replace enzyme functions. So it's important kind of to think upstream about some of those enzymes. And that's again, we're kind of thyroid plays a big role in that piece as well. Absolutely. There's a lot of controversy out there with this term leaky gut, right? There's so a lot of people will go to their doctor and they say, I think I have leaky gut, which may be a valid statement, but they just get, you know, ignored or they roll their eyes. Why is there so much controversy on this topic? And is there actual literature to support the fact that it is real? Yeah. Oh, yeah, there's plenty actually. Just call it intestinal hyperpermeability. Maybe you might have a better response with that. But, yeah, I mean, we have plenty of literature looking at that and including the autoimmune response. I mean, and we really understand, I mean, you can talk to your doctor too about the gut microbiome. And there's so many studies coming out looking at our microbiome, which is this collection of literally trillions of organisms that live within us and how that influences our health. Our gut microbiome itself is thought to be an endocrine organ. So it's very interesting. There's a lot we don't understand about it. And that's okay. I think we can just say, you know, there's a lot we don't understand about it, but we know that gut microbiome is really important when it comes to overall health, including your immune system. So an autoimmune in particular. Absolutely. And I think one thing that's important for people to do is remember that everybody's human, you know, even doctors and we're all learning together and everybody's busy. So if you've got some really good information, you know, and you want to present that to your doctor with research, that's always a good idea. I learn, and I'm sure you do too, so much from your patients. And we need to encourage people to be proactive and to share with their practitioners. 100%. I mean, I think you really have to be your own advocate in this world, but pick a guide who is sort of on your same page and has similar philosophies. But yeah, I mean, you know how hard it is. We see so many patients who have like been trying for a long time to heal, and they've just been doing it on their own. But it's really hard. I mean, you and I see hundreds of patients. We see tons of labs. I mean, we see these patterns because it's what we do for a living, but it's sort of like I've never been to try to fix my car. I'm going to take it to the car mechanic. And, you know, it's just it's hard. It's complicated. And it's as you know, it's not just one thing. It's like, you don't just have Hashimoto's because you have Sebo, usually the Sebo. You know, you have Sebo because you have hypothyroidism or you have some other sort of motility problems or peesions or whatever. I mean, it gets complicated. It's not just a simple kind of quick fix. You mind talking a little bit about Sebo because I know that it's something that you're really passionate about. And I think it's such a huge problem and it definitely correlates a lot with hypothyroidism. But, you know, what does what does Sebo mean? And you explain a little bit about how that's happened. So Sebo or S.I.B.O. A small intestine bacterial overgrowth and essentially our small intestine shouldn't have a ton of bacteria in it. Our large intestine has a lot of bacteria. So if that bacteria migrates to the small intestine, it becomes problematic because we're essentially fermenting a bunch of food in our upper gut in our small intestine. And that creates a lot of gas and bloating and malabsorption. And so stool can come out looking mushy like soft serve or it can look really hard and be very hard to pass depending on the kind of type of gas you're making. There's usually hydrogen gas, methane gas. There's also hydrogen sulfide gas, which we don't, there's kind of one test that'll it's at that. But, you know, testing and understanding, I mean, you could kind of tell symptomatically if somebody has hydrogen predominant Sebo or methane predominant Sebo based on their symptomatology most of the time. But if you get too much bacteria in that upper gut, it can just cause a lot of symptoms and those, it's usually the infection that is the cause of IBS, sort of like with peptic ulcer disease, the infection that is the cause of peptic ulcer disease is often helicobacter or pylori. In this case, Sebo is, you know, bacterial overgrowth of some sort. And so there's lots of reasons that we have Sebo and it's not just treat the Sebo, it goes away because a lot of people who have had Sebo treat the Sebo, it goes away for two weeks, comes back with a vengeance. And so we have to kind of look at like what are the upstream causes of Sebo. So there's a lot to that. Motility is a big one. So intestinal motor dysfunction, I mentioned earlier, is largely influenced by your thyroid gland. Stress is a big player there too for people who have endometriosis who have had abdominal surgeries or like a ruptured appendix or something like that. They might have adhesions, which can influence motility in our intestines. Be a set up for Sebo. Even oral health can be a set up for Sebo. So people who have a bad oral microbiome or issues in their mouth are swallowing that saliva all day. Sometimes that can see the upper gut. So there's lots of different things to consider. And then sort of thinking about that enzyme function as well. How do we break down our food? People who are on proton pump inhibitors can be predisposed. I mean, there's some interesting literature because not always. But can be predisposed to development of Sebo or even fungal overgrowth. So that's the other big thing I think is missing is with Sebo. You can have concurrent seafull, which is small intestine fungal overgrowth. you treat this. the SIBO without treating the SIFO, sometimes people have worsening symptoms. - Yeah, and that's pretty common, right? So if a lot of people go to the gastroenterologist with these IBS symptoms, at least now, they're starting to recognize it, which is really great. I mean, some people, but unfortunately, the early starts and ends with zyfaxin typically. So in antibiotic, which is a pretty decent antibiotic compared to some when we're treating this, but at the same time, like you said, they end up back in the same situation oftentimes a week or two or even a month later, because they're not addressing all of those other factors that caused it in the beginning. And I think asking that question of why is so important for all of us as practitioners and as patients to consider, because if we don't address the why that's driving the problem to begin with, you're gonna be right back at square one. - Yeah, learn that the hard way. - Right, right, we all have. So tell me a little bit, you know, you mentioned SIBO, and we could talk all day about that, and that's such a cool topic. We will have you on again to talk more about SIBO, but we mentioned that the problem, one of the big problems with SIBO was the malabsorption that happens. So people aren't absorbing their food, breaking it down and absorbing the nutrition. Why does nutrition matter when it comes to thyroid health or digestive health? - Yeah, so that's a really interesting one. So in order to make thyroid hormone, we need to search certain nutrients. Iron is on that list, B vitamins, tyrosine, which is an amino acid. And then in order to con- iodine also, I didn't mention, but that's an important one as well. And in order to convert T4 to T3 effectively, we need zinc and selenium. Vitamin A is a big influence there too. It really influences the cellular receptor sensitivity to thyroid hormone. So all of those nutrients are big deals when it comes to thyroid function, and they also happen to be pretty commonly depleted in patients who have Hashimoto's. So is it the chicken or the egg? I don't know. But nutrient depletion and thyroid function is an important link. - Absolutely. And so what should people do? Should they just go out and take all of those supplements just to help their thyroid? Or are there particular ways that people can really find out what their body is nourished in and what they're depleted in? - Yeah, I mean, always tests don't guess, right? Like ideally, if you're working with a practitioner who will test those levels, I check an RBC selenium and an RBC zinc. And many of my patients, especially those with thyroid issues, I also check a fasting vitamin A level, vitamin D, of course, and like everybody. You can check lots of B vitamins. The B vitamins are important too. I don't know about a measurement for tyrosine, but just if you see kind of overall malabsorption, it might have a bad idea to supplement with that. I and I'm pretty careful with. So don't go to the grocery store and buy 12.5 milligrams of iodine because that could be a really high dose that could actually give you thyroid dysfunction. So iodine is sort of like a Goldilocks hormone or nutrient rather, where it's not too much, not too little. You just need the right amount. So be pretty conservative with that one. But if you can work with a practitioner who will test your nutrients, then you will know exactly what you need more of. I think taking a basic multivitamin with things like methylated Bs and pre-formed vitamin A and the form of retinal palatate and sun amin zinc, I mean, that's a good idea for most people. But ultimately, like everybody's different. I don't have like one size fits all protocol for every patient with Hashimoto's because everybody's got a different issue. So-- - Exactly. - You and I both know that really well. But yeah, I mean, I think eating a nutrient dense diet is really important and it's never gonna hurt. So focusing on nutrient dense foods and supplementing with intention and with strategy rather than taking a bunch of stuff. - Right, I love that. You said that everybody is in a unique situation for different reasons. You may have the same diagnosis, but the reason you got there is totally different. And that's why we have to take an individualized approach as opposed to putting everybody on a cookie cutter protocol. - Yeah. - So for like if traditionally, if someone was to come in your office and they were to get a workup thyroid dysfunction or a digestive issue, what kind of testing would you do in comparison to what they would get done from their traditional primary care? - So I think if you go see primary care for a thyroid problem, you're usually gonna get a TSH. You might also get a free T4. And often it ends there. Sometimes they might check thyroid antibodies, might not. And then if you're having digestive issues, they'll refer you to a gastroenterologist who will maybe run a seabull breath test kind of, if you're lucky, like they don't depend, right? Some are great and some will run it and some don't. I see both sides. And in terms of GI workup, I mean, it really depends if you have some red flags like blood and your stool amicus and weight loss, they might do a colonoscopy. But if you really don't have any red flags and you see them several times for IBS, there's kind of a few medications that they might try prescribed. But that's sort of what the conventional workup looks like. And I think, you know, if you go see, come to my clinic, I'm going to get a full thyroid panel, which is a TSH free T4, free T3, as well as TPO, thyroid, or TPO, thyroid peroxidase, and TG, thyroid, glibulin antibodies. Sometimes I also look at a reverse T3, but a reverse T3 is not like a deal breaker when you're assessing thyroid function. And then in terms of GI issues, I mean, I of course also like to look at nutrients. So like I mentioned earlier, the RBC Selenium Zinc Vitamin A, Vitamin D, all that kind of stuff, almost as thin as a marker for B vitamins. So we can do lots of labs, and those are all labs that can be done at your conventional like lab core request. And then, you know, looking at the functional medicine labs, those help us really address some of the problems that we see in the gut. And so really trying to diagnose, first of all, what is the problem in the gut? So we can remove that infection. And so, you know, maybe it depends on history, it depends on sort of some of the risk factors and everything like that. But then I'll do a Cial Breast test. And so I'll do one of my phase organic acid testing. And that's actually urine test. But the first page looks at metabolites and nine of those metabolites are fungal markers. And then we get some big tumor markers there as well. I also do a DNA stool test called GIMAP, which looks at parasites. And you know, it's a very sensitive test. Sometimes we get some false positives on that test. So I'm just careful about the way that I interpret it. But you know, we can look for other kinds of infections. And then really importantly, I get some markers in the test to help things like a last day, which tells us a little bit about your pancreatic function, stiatic rate, which tells us if you're having fat and no absorption, calprotectin, which tells us if there's inflammation or like risk difference, or a lot of other bowel disease, something called secretory IgA, which is like the immune system of the gut. So really that collection of labs helps me decipher if somebody has thyroid dysfunction, gut dysfunction, autoimmunity, or all of those things kind of intertwined. And then we treat them all at the same time. Exactly, exactly. Because it takes a lot of the guesswork out. You know, I mean, you can guess, you can spend all day and a lot of money guessing and still feeling miserable, or you can do some comprehensive testing to really get some clarity on what's going on. And that helps us as practitioners really develop that clear cut plan. And like you said, it's not always just doing one thing at a time. We're doing multiple things at the same time around nutrition and lifestyle. And again, physiology with the testing. And that's where I think those outcomes just, I mean, they stand out and people do amazing when you hit all of those different factors. And it's never a quick fix and there's no magic bullet. But when you put all those pieces together, a lot of times good things happen. Well, can you do me a favor and just share patient stories as someone who maybe was struggling with thyroid issues or digestive issues who saw resolution with your functional approach? That would be awesome. Yeah, I mean, the first person who comes to mind is really myself, honestly. I mean, my gut issues, I'll just go personal with you. So I told you when I was kind of between pregnancies, I was like, something is wrong. I'm having miscarriages. And of course, my husband was like, it's not your fault, which was very kind, but I knew it was my body. No, it really, it's not my fault, but it's something wrong with my body. I know that. My gut's telling me that, like literally, my gut's telling me that. So I started really trying to figure out, first of all, what was wrong with my digestion because it wasn't normal. And it was causing me issues. And I was super bloated sometimes. It looked pregnant. It just didn't make sense. So I treated myself for C-Bell. Well, actually, I saw a gastroenterologist who tested me for C-Bell. He was great. And I was treated with cypaxin. And actually, I did great for like two weeks. And then I just got really, really bad, like worse than ever before. And I finally ended up doing organic acid testing and saw like massive fungal overgrowth. So that really told me something. And turned out I was getting exposed to mold. And so there was a lot of mold and kind of fungal elements in my environment that were causing, or at least, contributing to the fungal overgrowth. And so I addressed that, which was not a simple fix, as you know. But, you know, kind of over time, I mean, anti-funcles actually were really hugely helpful to me. I mean, made a really huge difference, but at the same time, I was also addressing thyroid dysfunction. So looking back at my thyroid labs, my TSH was around like maybe 3.9 at the highest. Like it was never outside of a normal range. And I had checked it actually very commonly because I have a sister with Hashimoto's and a sister with grace. So, you know, I knew like I said, I had a strong family history for this. So, but really looking at my T3, my T3 was like 2.2 or something. So again, it was in a normal range, but it was so low. And so I started initially taking natural-descated thyroid like armor. This point I'm on something called Terosin solution, which is a more absorbable form of T4, which I really like actually. It's really both our oxygen. And I take side amount, which is T3. But just in small doses and I keep my thyroid in a really optimal range. I mean, I think I always, I don't like to make, you know, too much medicine isn't a good thing either, right? There's like both sides of the coin. So I like, you know, I keep my T4 around 1.2 and my T3 around 3.4 or something like that. So, so anyways, I think really addressing my thyroid problem was part of recovering my gut function. And in my case, I never had constipation. It was just the intestinal motor dysfunction really. And I think a big player. was to like decrystance-ine production decrycitacity all of that. So I mean, it's a process, it's not something that like got better overnight. How long have we known each other since like 2016? Yeah. That's 2021. You know, and I still take a whole handful of supplements, when I still use HCL with meals actually and enzymes and all that, so yeah, it was a process, but definitely like, it was something that everything needed to be really dealt with at once. It wasn't like I could just ignore the environmental stuff. I couldn't ignore the digestive stuff. I couldn't ignore the virus stuff like it all really had to come together for me to get better. So I think that's a great story on just how complex and convoluted chronic issues can be super complex. It is and we can't just separate it into different systems and unfortunately we tend to do that as a medical society. And although these specialties are absolutely essential in certain situations, we need to be looking at the body as a whole and recognize that everything is interconnected and that's what I just love about the whole functional medicine approach. But well, that's a great story and I really appreciate your time here. Do you mind giving us a little bit of, I always like to ask, what is one health tip that everybody can implement at home today that can take them to the next level as far as their health goes? Is there anything that you can think of that comes to the top of your mind? I mean, the exercise, honestly, I know that's the most ridiculous thing you hear, right? You're always like diet and exercise, diet and exercise. But get your body moving every day, especially now we're sitting home in front of screens with artificial light. So I think really it's like, get your body moving. I think one of the best things I've done in the past year of since COVID sort of started was getting a peloton. That's changed my life. I feel awesome. I love my bike. But do something that keeps you active. Exercise is actually good for your gut microbiome too. Good for your mental health. You know, don't neglect that piece of the puzzle. Right. There's all the literature that comes out that compares exercise to all of these interventions. Exercise always wins. You know, if people can get on that bandwagon, man, they just takes their health to a whole another level. Well, that's great. Well, thank you so much for sharing your story and your wisdom and your information. If someone wants to learn more about you and your practice, how do they get in touch with you? So my website is drkristinemarin.com. So it's drchristine.inemahrn.com. So you'll find all my articles on thyroid and reproductive health and everything like that there. And then I'm also on Instagram. I hang out there a lot. So my handles just at drkristinemarin. I'm on Facebook sometimes too, but you're more likely to find me on Instagram. So awesome. And we'll be sure to put that in the show now. It's well, thank you so much for your time today. I really appreciate it. And I look forward to chatting again here in the near future. Yeah, of course. Thanks. All right. Bye. Thank you so much for listening guys to find more practical tips to improve your state of wellness. Don't forget to join us in the grassroots private Facebook group. Just search grassroots community on Facebook to join. And if you're sick and tired of being sick and tired and you're looking for a comprehensive program to reclaim your health, check out our ad at patient programs at grassrootsfunctionalmedicine.com. We'll help you uncover the root causes of dysfunction, create a structured plan of action and hold you accountable with regular check ins so you can get well and stay well in the years to come. Thanks again for listening and have a blessed day.