I have a killer immune support tip because let's be honest, cold and flu season can be an absolute doozy. We've already been hit multiple times and had to do multiple rounds of antibiotics. And I have been researching the heck out of exactly what nutrients and herbs are evident space and actually make a difference. The really cool news is I just found out that MD Logic has a comprehensive immune support supplement known as Immuno Logic that literally has everything you'd want. I just started taking it this week since we've had a new round of colds. It has a natural form of vitamin C from organic acerola extract, zinc, echinasia, oregano, garlic, queer citin, one of my favorites, and even B-properlyce. All of these nutrients have immune supporting effects and can help reduce the frequency of cold and flu's and may help regulate the inflammatory response and shorten your sicknesses if you do get sick. I recommend ordering a few bottles and having them on hand, that is what I have done. Anytime anyone gets sick in your house starts supplementing with it daily and of course you can use this as a first defense at the first sign of sickness since it has both immune supportive herbs and antimicrobial extracts like olive leaf and garlic. I'm going to be honest with you. I will never now be without this. I treat it as a first defense. So when I start noticing, I've got a little bit of a tickle in my throat. I immediately start taking it. If I need to add an probiotic and a prebiotic, I usually take that every day anyway. But in general, this literally has all of the evidence based nutrients I've previously been taking individually. It also only uses monolorin as the flow agent and is always tested for contaminants like heavy metals and mold. To grab yours, go to mdlogichealth.com/immuno. That's immm UNO. Use the code well fed for 10% off. Again, that's mdlogichealth.cogish.com/immuno. That's immm UNO. Use code well fed for 10% off and you always get free shipping on orders of $50 or more. You are now listening to Well fed women. The show that's been radically changing the way women perceive health, fitness and their bodies since 2015. I'm your host, Noel Tar. Submit your questions to well fed
[email protected]. And you can keep up with the show on Instagram @WellFedWomen. Hello, friends. Welcome back to the Well fed women podcast. This is episode number 457. And today I have on Dr. Christine Marin, who is a DO and is a board certified physician and founder of a virtual functional medicine practice. She practices specifically in Colorado, Michigan and Texas. She is very knowledgeable in all things thyroid hormones, Hashimoto's, hypothyroidism and even how other hormones play a role in your family. And we dive deep into your confusing thyroid symptoms, connect some dots. Hopefully a lot of light bulbs will be going off. We also do talk about labs and functional ranges. So I actually went back and re listened took notes and listed all of the ranges in the show notes for you. So you can always reference it there. She is incredibly knowledgeable. She's actually a functional medicine approach, address her own underlying health issues after struggling with pregnancy complications and miscarriages. And now she's a mom of three and she's devoted her professional life to helping others find the root cause of their symptoms so they can reclaim their health and restore faith in the body's ability to heal. She specializes specifically in gut health hormones, Hashimoto's and other autoimmune conditions. She's a board certified by the American board of family medicine and is an institute of functional medicine certified practitioner. I loved my conversation with her. And I think I've been following her on Instagram. And I think a lot of you are going to find a lot of really helpful information. If you know anybody who struggles with thyroid issues, Hashimoto's or even hypothyroidism. This is a great episode for you to send their way. And hopefully this is really helpful for you as well. So I hope you're going to help further do let me bring on Dr. Marin. So welcome, Dr. Marin to the Welfare Women podcast. I'm so excited that you're here because when I post these questions, I said, Hey guys, I'm having an expert coming on. Give me all your confusing and unsolved hormone and thyroid issues and man. I'm a lot of them. So I'm really thrilled that you're taking the time out of your day to be here. So thank you. I'm so happy to be here. I love talking about thyroid and women's health and hormones. So it's my pleasure. And you have a pretty robust clinical practice that you work with people mostly virtually or what where have you gotten a lot of your clinical experience from? I work with patients virtually in Colorado, Michigan and Texas. Long story short, I was born and raised in Colorado and I went to med school in Chicago. I did my family medicine residency in Texas. And I married my husband who it was a military doctor. We subsequently moved to Detroit where he did a fellowship. And so my practice sort of followed. And then eventually made it back home to Colorado. Awesome. And so is he still in? No, he is not in the military anymore. Got it. That's great. So you're kind of well-rounded. Yeah. Yeah. Cool. Okay. So obviously you are an expert when it comes to taking a functional root cause approach to hypothyroidism and Hashimoto's. And so we've done a lot of episodes about that previously deciphering between the two also talking about how common it is that women actually have Hashimoto's even when their doctors just saying it's hypothyroidism. What is one thing that people who are trying to do everything right? And then you're missing when it comes to their thyroid health, maybe in your clinical practice, what are you most what are some of those common things that people just aren't doing right. I would say the biggest thing is really tapping into stress management, which is like such a loaded word. And it kind of makes me crazy sometimes like I by no means dismiss symptoms like, oh, it's just due to stress, right? And so that's what I think is due to stress. But many of us have been sort of functioning in this like sympathetic overdrive state and our nervous system is dysregulated. And it's often the last thing to be addressed because it's probably the hardest thing to be addressed right it takes a lot of work. It's often working with like a great therapist or energy worker, whatever it might be unpacking childhood patterns. And often those are subconscious patterns that people aren't even aware of, but they do affect our ability to function in the world and they affect our hormones. I think for me, most of my patients are trying many of my patients are trying to address dietary issues and then they are working to address issues with, you know, toxin exposure and things like that. Most of my patients are, you know, somewhat well versed in that kind of stuff, but it's just the nervous system piece. And honestly, I can totally relate to that 100 million percent. Like, yeah, that's kind of the last rabbit hole I went down. Yes, I totally nailed it. I feel like someone said something recently to me, which was so profound, which is a lot of times. And this is the way that I think a lot of us work. And when I get a lab, we want to get a test and we want to fix the test, we want to fix the lab. My numbers are wrong. How can I fix that as opposed to saying, how do I fix what's causing this dysfunction and causing those numbers to be wrong. And it is so much easier just to say, oh, well, it's this toxin that's causing the problem or it's this gut bacteria that's causing the problem or it's, you know, it's this thing that I've looked at that this lab says is wrong. And so I've got to fix that that circle. And so we go on a track to fix that one thing to resolve that one thing that's off on a lab. And then we do we take the pill, we do the detox, whatever, and the health symptoms are still there. Yeah. And that can be so frustrating or women. I think it's just also like it's a soup. Like, there's a bunch of logs in the fire. And we've got to take a lot of those logs out of the fire. And so it is important to address the diet piece. It is important to address the toxin piece. But we also have to address the nervous system dysfunction that we've been living with for 30 years or whatever it is. How does somebody do that? What are your recommendations? I mean, this is, I mean, it's it's loaded in there's so many different ways. I think finding a really great therapist can be great for people who can afford that and who are sort of open to that and just really kind of digging into like what's there, but it like it with everything. And the right doctor, find your right therapist find the right yoga instructor like you've got to find the right person for you. I really like work from Gabo or Mate he has a book called the myth of normal. So if this is like four into people start with that book. Chapter five six seven he talks a lot about sort of how our childhood upbringing really frames how our immune system works. That was very eye opening for me because I used to sort of think well stress is like the straw that breaks the camel's back and in a way it can be, but it also can be the thing that primes us for immune system dysfunction auto immune disease. And ultimately it's like, you know, our brain.
bodies are designed for survival. So we have to think of this from this like primal standpoint, you know, where we're designed. But anyhow, working with the therapist, another great resource aside from Gabar Mate, I follow the holistic psychologist. She's got some great resources and great like workbooks. And personally, like I practice meditation, literally 10 minutes a day, I try to practice like really grounding, like bringing energy into my feet into the ground. It sounds kind of woo-woo for people, but it's real. You know, the basic stuff, like sleeping well, and making sure your blood sugar is balanced. Like these aren't things that we can ignore, especially when we have thyroid issues. When it comes to nutrition, not just like restrictive diet, but making sure your body is really nourished. Yeah. Often with thyroid, I'm like, no, wait, intermittent fasting, there's time and place for that. But for people with thyroid issues, my goal is really like, let's try to tell your nervous system that you're safe. The goal here is safety. Montras can be helpful. And sort of avoid it like right now, the news is just painful. For me, it's a little too much. And so I have to really screen sort of what do I see? What do I want to see? What do I want to let myself see? Because I don't need any signals to my nervous system that I'm unsafe and I need to protect myself. Like that's the last thing I need to, you know, here. Some people, you know, we all have different thresholds. Being out in nature is, you know, critical. I think most of us don't get outside very much, especially in the winter. You know, we're just like, cardabilding. And I think even in the cold weather, that can be super important in healing for our nervous system. Yeah. It's crazy. You just mentioned like all that we're observing and what we have to be selective about what we take on and what we see. Because never in the history of the world have we been able to be exposed to so much brokenness and so much conflict. And people, I just can't imagine their mental and emotional people who are deep in comments and fighting back and forth with literal strangers. Yeah. And over certain issues and we get so wrapped up in this almost, it's not an alternative universe. It kind of feels like it, right? Like where we're all battling. It's all conflict. All we're seeing is the bad from every, all around the world. You know, it's not just what's happening in your state or your neighborhood or your, your, you know, country. It's all over the world and everybody wants to like get their opinion out there. And sometimes actually most of the time, all of the time, it's like, it's not going to change anything, right? It's not you're not changing any minds by fighting and and being super combative. And so I think it's so important that we are just super intentional. There's the, especially with AI and what's all happening now with like what we're seeing is not real. Yeah. Right. Exactly. Like what we see isn't always real. Like there's so much propaganda out there. Yeah. I mean, I think when we're trying to change the world and make a difference, it really is important to just start inside with yourself. Yeah. Absolutely. So let's focus more on the thyroid stuff. So a common reason that many practitioners say you don't need to test your antibodies. And I'm sure so many women, everybody who's dealt with thyroid issues has heard this is that when someone is hypothyroid, it's not going to change anything. It's not going to change the diagnosis. It's not going to change how you actually treat it with, you know, synthetic hormones or not synthetic hormones. You know, however, you, you're going to treat it. You're just going to give somebody thyroid hormone. And that's just how it's going to be. We don't need to know. We don't need to test regularly. That's something my husband keeps hearing. We test it once we're good. We don't need to keep looking. Why do we know? I'm not going to prescribe you an opportunity to keep looking at your numbers. You don't need to see it again. We already know your Hashimoto's. So how do you in your practice treat hypothyroidism and Hashimoto's differently? True hypothyroidism and Hashimoto's. Yeah, totally. It's a great question and just like a little background. I mean, I did my residency in family medicine. And so I was taught. I actually remember having a patient where I'm like, oh, he has positive antibodies. Like, what what do I do with these? Like it doesn't, doesn't matter. I didn't know what to do with them at that time. So, you know, doctors in the conventional paratime aren't taught that those antibodies even decrease. And I will say over and over again, that antibodies decrease as clinically you start to feel better. Like I see it with patients all the time. So I have zero doubt in my mind that this is something that happens. But the general thought is that it's not. And so, you know, like you said, we're just not like really checking antibodies. Like, first of all, I don't believe that that antibodies are checked often enough. Just when somebody has a hypothyroid diagnosis, we need to know, is it because of Hashimoto's or not? And then continue to follow them over time so that we can see if the autoimmune process is worsening or if our interventions are making them better. And so when I talk to patients with hypothyroidism, this is a hormone system or a hormone deficiency. And so if somebody has true hypothyroidism and we're replacing that with medications, that's sort of one piece of the puzzle. Also there, like we want to make sure we have adequate nutrients to make thyroid hormone and do a lot of all this stuff. But it really is thyroid hormone is a hormone deficiency or hypothyroidism rather is a hormone deficiency. Hashimoto's is an immune system problem. Over time, that immune system problem can cause hypothyroidism, but sometimes people have Hashimoto's without hypothyroidism. So initially can present as Hashimoto's, but you can have normal thyroid function, especially if you find it early in the stages of Hashimoto's. So people might have a positive thyroid proxidation antibody, but a totally normal TSH. Now I'm more likely to treat them with thyroid hormone if their thyroid is subclinical. So maybe their TSH isn't super high, but it's over two and a half and they have symptoms. And Hashimoto's, I'd be more likely to treat somebody with thyroid medication because of that. But nonetheless, when it comes to the immune system, dysfunction piece, that really is rooted in toxins, infection, and trauma. So that trauma piece goes back to what we talked about first with stress. The toxin piece, often is there's a lot of toxins that we get involved or that we get exposed to between plastics and fluoride and mold and all that kind of stuff. But the gut health piece or the intestinal permeability piece often has a lot to do with the infection, infectious burden. And so I focus there a lot. And that's, you know, often where I start because there's such a connection between people who have thyroid dysfunction or Hashimoto's or both and gut health issues or digestive symptoms. Yeah. Yeah, that's incredible. I, um, do you find, you answered one of my questions, which is your antibodies can decrease, which I think's really, really encouraging because if you have that little marker, even if you necessarily don't feel, you can't really tell. Sometimes we lose touch with our body and we don't necessarily know, are we actually feeling better? Do you have the marker that your antibodies are going down? Like, I feel like that's really, really encouraging. Yeah. With hypothyroidism, you mentioned making sure that your body is nourished. What are some causes of hypothyroidism that are not Hashimoto's? Like why are women struggling with that? Why would their thyroid not be forming? It's so pervasive. And I've asked myself this a lot and there's not really just one answer. I think toxins are a gigantic piece of that puzzle because there is a, there are a lot of women who have low thyroid function without having Hashimoto's. Now, the majority of women in America who have hypothyroidism have Hashimoto's, but even just like subclinical hypothyroidism, I see a lot of women in that category, especially women who are trying to conceive because it can affect fertility a lot. So I think toxins is a really big piece. I mean, we get exposed to fluoride and bromine and chlorine every single day. And those things can disrupt thyroid function and displace iodine, which is important for thyroid function. So I think that's a piece of it. I mean, nutrient depletions are a piece of it. You know, iron deficiency, B-vitamin deficiency, iodine deficiency. It's not as easy as just replacing it, but zinc, selenium, vitamin D, like all of those play a role in thyroid dysfunction and hypothyroidism as well. And just the production, our ability to make thyroid hormone. And then the stress piece, you know, plays a role. It's like a primal kind of survival mechanism where we're sort of like shutting metabolism down. Yeah, I've seen the studies that talk about how like chronic cortisol production actually decreases thyroid function. Like it's a direct connection. It's not like, yeah. Let's hypothesize, like, there's a direct connection there. So yeah. So talk about the gut thyroid connection, because a lot of women obviously who I think struggle with thyroid issues also have gut issues. So what? Which comes first and how do they do that? Totally. It's like the chicken or the egg. I don't know which came first. And it really depends on the person. I mean, often this is, I look at at sort of a timeline with patients like what happened when, what were triggers, but we still don't always know. So I mentioned earlier in test all permeability. This is hyper permeability. This is what people call leaky gut. And so if there's this leaky gut, antigens are presenting to our immune system that we shouldn't really see. And that can worsen or be a nitrous for an autoimmune disease like Hashimoto's. So that is part of the connection. There's a very strong connection between a certain gut infection called CBO, small intestine bacterial overgrowth and Hashimoto's like more than 50% of patients who have Hashimoto's have seen.
So having something that disrupts intestinal permeability can play a role with the autoimmune disease. The other piece of that is like when we convert thyroid hormone, we make TSH, TSH tells our thyroid to make T4, T4 gets converted to T3, but that conversion happens outside of the thyroid. So that conversion, that's not a thyroid issue. That's like a, what's happening in your microbiome and your liver and with bile acids. So that's where gut is heavily involved in that conversion process. So sometimes people think they have hypothyroidism when they have a low free T3, but that's not, you know, that's usually, we got to look elsewhere. Like we got to start looking at gut and liver and gallbladder. And then thyroid influences the gut. Those were ways that the gut influences thyroid function, but thyroid also influences the gut in a really big way. People with hypothyroidism and with Hashimoto specifically are more likely to have dry mouth. So I was really important for digestion. We're likely to have low stomach acid. That's why sometimes we supplement with Bt. HCl. It definitely affects gut motility, which is probably a big part of the reason why patients with hypothyroidism and Hashimoto's often have things like SIBO or bacterial overgrowth in the small intestine. It is also, we know very well, like one of the symptoms of hypothyroidism is constipation, but just a dust of dysfunction in general. Sometimes it's loose stool, bloating, belching, gas, that kind of stuff is also, those are also symptoms of hypothyroidism and Hashimoto's. I always say, so the thyroid influences metabolism throughout the body, including the intestinal viscera, which means like our thyroid is talking to our gallbladder and our liver intestines and like playing a role in squirting out digestive enzymes and stomach acid and actually having adequate motility. So there's a big overlap there. 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I almost think of it as motility dysfunction. So the migrating motor complex in our gut should sweep food through and sometimes that doesn't happen. And so we have this enteric nervous system. It goes back to the stress piece too and the stress and trauma piece. Also, it's kind of loaded but it can go back to like having things like food poisoning that can really mess with the nerves in the gut. So they get an enteric nervous system. This is where it's like, well, maybe you had food poisoning, food poisoning set you up for SIBO. And then SIBO got really bad and you ate a lot of gluten and you had worsening intestinal permeability. And then that was like gene slow of the gut environment pool is the trigger. Now you've got hashi motos, but we don't really know what came first, the chicken or the egg because we haven't been testing all these labs for your whole life. And we didn't think to test them when you had food poisoning. So interesting. Yeah. So if someone has these unexplained digestive and thyroid issues, what test should they be asking for? And what are your functional ranges for TSH? Because you mentioned 2.5. Most people I think it's still 5. Yeah. Like 4.5 or 5. Yeah. In an ideal world, what I check is a TSH, a free T4, a free T3. I like to check reverse T3, TPO, thyroid peroxidase and thyroid glabulin antibodies. In pregnancy, I check total T4 and total T3 instead of free T3 and free T4. But outside of pregnancy, I looked at the free T4 and free T3. If your doctor is not willing to check all of those labs, I would ask for a TSH and a free T4 at the very least, often what's checked is a TSH with a reflex to free T4. And what that means is we're going to check TSH, but unless it's outside of the normal range, so unless it's pretty high at 5, we're not checking free T4. And then we just completely miss like a whole diagnosis called secondary hypothyroidism when people have a low free T4, but a normal TSH. So most endocrinologists will check a TSH and a free T4, but most primary care doctors check a TSH with a reflex to a free T4. So I would check out TSH, free T4 at the very least. If you can get them to check a free T3, great. Reverse T3 a lot of times people sort of push back on and you don't have to fight super hard for it. Like it's nice to have, but I feel really strongly about checking thyroid antibodies for anybody who's struggling with chronic symptoms because I can't even tell you how many patients I see who say I've been sick for five years. Nobody can find out what's wrong with me. My labs are all normal, but nobody ever checked them. And they have Hashimoto's. I'm like, you've had Hashimoto's for 10 years. Like, wow. That's, you know, because like I said earlier, like the Hashimoto's usually comes first and then eventually that causes hypothyroidism. Yeah. But in conventional medicine, we're sort of looking at it the other way where we're saying we don't really even test for Hashimoto's unless you have hypothyroidism. Wow. Yeah. But if there's lots of symptoms going on like anxiety and gut dysfunction and stuff like that, we ought to check it. It's cheap. Honestly, like these labs aren't expensive, but they're widely available. And, you know, I'm always like a risk-benefit kind of person like, well, what's the risk? Yeah. Right. We're already drawing your blood. Yeah. That's, I mean, you know, it's not like a $3,000 lab, you know, like maybe $38 or something. So, yeah. And what are your functional ranges for TSA? Yes. So functional ranges. I mean, I say with TSH, I'd like it close to one. One to two is sort of my ideal. A little lower than one I'm totally comfortable with with free T4. I'd like to see it between 1.1 and 1.4, 1.5. And with free T3, I'd like to see it between 3.2 and 3.8. Okay. Everybody's got to rewind that and write down the case for that. Yeah. If you're on thyroid medication, it depends what kind of medication my patients are on, but I'll give them timing parameters. Like, have this drawn fasting before you take your thyroid medication or for people who are on a T3 medication, I really like to check those labs four to six hours after they take their medicine so that we have some idea of how high their T3 is going because otherwise, I've no clue how high, you know, do we need more side-amel? Maybe you don't need it. Like, not everybody needs T3 or armor. And I'm not interested in giving people too much T3 because that can perpetuate anxiety, increased risk for palpitations, bone loss, things like that. Okay. This is from Katie and this is a very popular question. She says, people always say, find the root cause, which can be an obsession in and of itself. That's my side note. Like, it's so easy. How is someone supposed to go about finding the root cause to Hashimoto's? Yeah, that's where it's like working with somebody who does this all the time. I mean, you know, I think I think it's really hard to do it on your own. I mean, this is, you know, I do this every day with patients all day long. So I see the patterns, but for people who can't work with a functional medicine doctor and can't do some of these testing, option, don't have the tests available to them. I think just assume there's like trauma toxins infection. Start with gut. If you have digestive symptoms, it's very obvious. If you don't, you might even still consider like, is there sea bow? Because it's so common, especially if antibodies are really high and then sort of consider, I think it's a good exercise, honestly, like really creating your own health timeline. Like, how was I, you know, birth to now? What I tend to hear a lot, like the big trend I hear in lots of my patients is they had lots antibiotics when they were a kid, some childhood trauma, like a parent who was an alcoholic or neglect or sometimes sexual abuse or the big trauma. And so those are like always things to sort of like, we have to go back to that and work on it. And then, you know, normally there's, I think honestly that like early life stuff is just like such such a big primer.
And then there's like, you know, often some other trigger, like sometimes people tell me they moved into a house where there was mold. And like, you know, it's never been the same or pregnancy is a big one or miscarriages. Kind of things can be hard on the immune system. Yeah. So it's like a big stressful event or something that happened or maybe like an environmental, a big environmental trigger. So like my husband was overseas and was exposed to certain things. And that I think that that's what what happened. But I do I feel like that's like some sort of exposure to some environmental toxin or which is hard because like we live in a toxic world. Yeah. Right. Pin pointing that thing is hard. But what you're saying is some, I mean, to me, it's like, okay, you find find your root cause. But ultimately what we're trying to do, even if it was this one thing or this exposure, ultimately what you're trying to do is support your body so that it can properly detoxify and you're supporting your body with nutrients so that it has the resources that it needs to function properly. And I almost think of it more of like taking the logs out of the fire. Yes. You know, because there's not like one root cause like, just take the glute now. It's not just the gluten now. Like you got to address the water filtration and you know, whatever you're breathing in when you take a shower. Like, and it's just you just got to kind of start doing these things sort of one at a time until it just becomes part of your lifestyle because it's not like a diet. Yes. You know, I think filtering things out of your water and your air, all that's really good. But if you're still not focusing on the foundational things, like you said, your nervous system and stress piece and all of that and even the early childhood trauma or thing, the way that you learned to operate. And so therefore your nervous system is hypervigilant and chronically activated like that stuff can help, but it's not necessarily going to be the thing. So yeah. All right. I have a one last question before we get into the questions from the community. What are some key supplements? This is the question, right? What can I take? Can you stop with for people with Hashimoto's or hypothyroidism? This is where it's really helpful to have blood work. And it can be simple, but like if you're anemic, we need to fix that. And it might be iron and it might be 12 or full later, you know, something else. But I think investigating first what you actually need and then supplementing from there because it's not like a there's not like one size fits all protocol. You know, everybody's always like, what's your protocol? Like, well, it depends on your laughs. What's your vitamin D level? What's your homocysteine level? What's your iron level? So I think making sure you have adequate nutrients. I mean, if somebody's trying to keep it really simple and they were female, I'd probably do a multivitamin with iron. And that's keeping it really simple. It's not what I typically recommend for my patients. What I'm recommending for my patients is usually like some sort of methylated B complex, a D3K2. Occasionally, I'll use a small dose of iodine for patients who don't have Hashimoto's but have hypothyroidism and low iodine. They're like for the stress response. I mean, ashwaganda, there are some good studies there. I like to use a lot and people who have a lot of stress or trouble sleeping, things like that. I mean, it's just it's such a hard question because there's just like not one thing that fixes it, right? Yeah, I'm a big fan of vitamin A. Yeah, right. I'm a big fan of vitamin A, not in patients who are trying to conceive pregnant or breastfeeding, but vitamin A can improve cellular receptor sensitivity to thyroid hormones. So can exercise. So I, I think vitamin A is underused personally. It's great for skin too. And antioxidants are great, you know, but I think like for somebody who's just trying to keep it really, really simple, I do a really high quality multivitamin with iron, something with methylated B complex. When you pick up a multivitamin, I am not talking like go to your Costco or Kroger or whatever. Like you need to get on, I'm a big advocate for pharmaceutical grade supplements. Like you get what you pay for kind of thing. And usually if you look at my my like cheat sheet kind of thing is like look at the back of the bottle. If it says fullic acid, move on. If it says cyanocobalamin move on, like they're not using high quality substrates. So yeah, I don't know. That's not like a super easy answer to that question, which sounds really simple. Health never is simple. Okay, questions from the community. These are some, you know, we're going to get down and dirty. This is from Lacey. She says, I seriously have no idea where to start. I have thyroid antibodies and definitely have symptoms of autoimmune issues or maybe hormonal issues. I have heard parasites, heavy metals, balance hormones, fix your gut issues, get old dental issues, checked, etc. I don't have the time or money to check every single one of those. These are somewhere simple that I should begin. Yeah. This really brings up the dental amalgam issue as well. I am also a really big proponent of integrative dentistry and safe removal of mercury amalgam. So our silver, if you have silver fillings and you have Hashimoto's, I would consider having those removed, but only with somebody who does that safely. IAOMT is a good resource for that. And they talk about safe removal of mercury amalgam so you don't get exposed to more. But that's not a simple solution. I would just sort of think like, okay, somewhere on the list, like these are things ideally that should happen and they don't all happen at the same time, they happen over time. So I think a good place to start is diet, which is where most people start. I would do gluten-free and I would just focus on real Whole Foods. I wouldn't go super restrictive. I don't think that most people need to go like autoimmune paleo, but you know, you could follow like a maybe loosely paleo template if that's helpful, but I think in general focusing on gluten-free and blood sugar balance and whole real nourishing foods, healthy fats, avocados, nuts, seeds, eggs, and healthy proteins and you know, fruits and vegetables. So, and then I'd really focus on gut health. I think for somebody who has digestive symptoms, the bulk of people I work with have things like bloating gas, belching, and loose stool, maybe constipation. Those are signs of SIBO. It depends on history. Sometimes I see fungal overgrowth as well, but there are some like herbal combos that you could try. So one of the ones I often use is candy-backed in ARBR. That's from Medagenix. And so you could do like an herbal kind of gut sort of reset. It's not like my go-to for all patients, oftentimes for patients with SIBO. I actually prescribe a medication, but I've seen it help people, for sure. Like my husband's medical assistant was like, you saved me. I'm like all better. That's great. Well, that was easy. Yeah, sometimes it works sort of a broad spectrum herbal combo that can help with potentially parasites, but I think really just paying attention to history. Like, if you're having anal itching and unexplained weight loss and you got sick in Mexico, like you might want to think more about parasites. Parasites is kind of a loaded one, I think, because I think it just goes back to like our Western microbiome is not super robust, you know? Like hygiene hypothesis. We are more likely to get sick and get foodborne illness and then we're more likely to get like basically poisoning of our inter-nervous system because of that. So that's sort of like this setup for SIBO. But nonetheless, I think if you have digestive symptoms, pay close attention there. You could see your primary care gastroenterologist and ask them about it. They don't always have great answers for that, but I think ask about SIBO, you know, is a good place to start. Toxins, like work on the gut stuff, work on food, work on toxic exposure. So filter your water, filter your air, try to clean food, meaning avoiding pesticides. Don't try to make it something that is so obsessive that you feel unsafe in your own home where you're like, I can't eat anything because it's wrapped in plastic. Like, you just have to do our best. It's 80-20. It's not perfect. You just do your best to clean up where you can and honestly, that's just important for lifelong health and decreasing your risk of things like cancer. And it's good for your children if you have them, things like that. I think back to that analogy, like just pulling out the logs out of the fire. Like, if somebody, you know, she says parasites, heavy metals, I think bouncing hormones, fixing gut issues, I would work on gut first and then hormones later because you've got can influence hormones. Like for people who have digestive issues, if you can fix that piece, often the hormones get better. If they don't, then I think it's a place to explore, but it's not always super simple. And I don't think you have to check every one of them, you know, if you can just sort of empty the bucket, like things often get better and your body sort of spins back into orbit. Yeah, I like that. This is from Kim. She says, I have Hashimoto's and two other autoimmune diseases. And I think it's because of decades of gut issues. I have many questions about thyroid antibodies. How often do I test and how do I actually reduce antibodies? And then she also says, which is the age old question, she says, how do I tell the difference between my thyroid problems and my 40s hormones, ug. Yeah. How often do you test and what are your, what ways do you actually reduce antibodies when you have the diagnosis of Hashimoto's? So I say like the easy ways are gluten-free diet and maybe low-dose naltrexone. I use that medication pretty often and it can help reduce antibodies. The harder ways are addressing gut issues because you first have to identify what the problem is. It can be multifactorial. So there's upstream factors, which we mentioned earlier, how thyroid influences your gut. So if you have low stomach acid or low digestive enzyme function, like you might benefit from a digestive enzyme. When I work with gut patients, it's remove and replace, remove gluten [BLANK_AUDIO]
inflammatory foods or food sensitivities, remove the infection, which we have to first identify and replace the enzyme. So if you can identify what the gut infection is, that would be great. And then I'd also use some sort of digestive enzyme. You could go through the whole process of testing the Tain HCl and like figuring out if and how much you need it or you could use a broad spectrum digestive enzyme, like digestive enzyme from designs for health is one that I use. And it has HCl Oxbile and pancreatic enzymes. So you know, gluten free diet maybe if Kim doesn't have access to seeing a gastrointrologist or primary care doctor who can help identify whatever's going on with her digestion, then she could try some herbs. I do always think it is important to see, you know, somebody and make sure there's no red flags like for people who have unexplained weight loss and blood and mucus in the stool. Like if you have one autoimmune disease, you're likely to have others and some of those autoimmune diseases can affect your gut like all sorts of colitis and crowns. So I always think about that kind of stuff and those are questions I ask patients. But how often I test antibody sort of depends on interventions. If I make a major intervention, like let's start Lotus and I'll track some. I'm going to check antibody 68 weeks later, maybe three months. So most of my patients with Hashimoto's I'm checking antibodies like my least every three months. For patients who are stable, like I have Hashimoto's, I probably check my antibodies every six months or so. But if something, if I'm not feeling good or I'm feeling off or something super stressful happens or I have a baby, I'm checking those antibodies more often. So reducing antibodies, I see antibodies reduce gluten-free diet, Lotus and I'll track zone. Zyfaxin is a huge one that I find super helpful. Zyfaxins and medication used to treat CBO. I mentioned candy back to an ARBR. I prefer Zyfaxin. It's better tolerated. Back to the risk benefit piece. It's a pharmaceutical but actually kind of lower risk than candy back to an ARBR and some instances and better tolerated. So if you have access to that and you're doctorable, prescribe it and it's appropriate, you don't want to use it if it's not appropriate. But it's something we use for CBO. And so if you have CBO, use it. I think it's a good medication. I use a lot. Over the years, I sort of learned like the herbal doesn't work as well and it's not as well tolerated. So anyhow, those are ways that will seem come down and like working on the stress piece and this simple stuff like get good sleep, prioritize sleep. Don't watch TV till midnight and then go to bed and wake up at six in the morning. Go outside, walk every day, get some exercise. Don't get too much exercise where you're depleting your body and sort of sending signals of like, oh gosh, I'm getting chased by a lion. But if you can lift weights and walk every day and get outside, that's great for thyroid function. And when I mentioned cellular receptor sensitivity, exercise improves that for hormones. And so I didn't know that fact. That's really cool. Exercise is so important. And like, I think in the thyroid community, it's like people get this message sometimes that you shouldn't exercise. Like stop exercising because you have Hashimoto's. You shouldn't do that anymore. Now, I'm not talking about like getting on the treadmill, like going to bed at midnight, waking up at six a.m. getting on a treadmill for an hour like that's not, you know, that's not doing anything for us. But I'm a bit advocate for weightlifting. Yes. You like, I haven't like ultimately do what you like. I go, I dance on Tuesday nights and I, you know, play pickled all sometimes. Like, whatever you like to do, just do this. Yes. I love that. Walk your dog. What do you, what kind of dance do you do on Tuesday nights? I do hip hop. Oh, that's fun. That's really fun. That's cool. It is like my favorite night. Hip hop with Julie. That's really stress reliever right there. I mean, it's awesome. Yeah. It's really fun. Now that I am approaching 40, I've been using adaptogens to manage stress, a lack of sleep and cycle changes, especially during cold and flu season when the kids are up all throughout the night. I love supplementing with Ashwagandha mid morning to help my body manage stress or lack of sleep or even when we're traveling. I also love Vitax or Chase Berry. There is so much research on how it helps relieve PMS symptoms like headaches and mood changes and even cycle irregularities. And the only place I get adaptogen blends is from Organifi. They have clinical doses of adaptogen blends and they make them in really good tasting drinks. 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There are clinical doses of adaptogens so you actually feel the difference. Go to organifi.com, Ford/Welfed and use code "Welfed" for 20% off. That's Organifi.organif.com. Ford/Welfed use code "Welfed" for 20% off your entire order. So this is another question. I know a lot of women do have hormone symptoms and some of those are very similar to thyroid symptoms, especially as we enter parimenopause. How do you know the difference between thyroid issues and hormone issues? Yeah, I mean, get the thyroid optimized first and see if they're still there. I kind of stick with that. Getting on an appropriate thyroid medication and the right kind of combination is important. Thyroid symptoms can definitely look like anxiety, sometimes depression, feeling cold all the time, slow metabolism, thinning hair, thinning of the outer third of the eyebrow, sometimes constipation, with hormones, especially in the parimenopause. Thyroid can definitely contribute to an ovulation or not, you know, not ovulating and therefore having irregular menstrual cycles. So if that's something that happens to you, it is tricky. So get your thyroid right and figure out what's going on with your hormones. You could test too. If you think you're in parimenopause, you can test certain things like FSH and LH on day three to five of your cycle. If it's pretty high, that would indicate, yeah, it could be parimenopause. If you're having things like vaginal dryness and hot flashes, often that's more parimenopause. Like I see that more with estrogen deficiency than I do with thyroid, unless you might be having hot flashes if you're taking too much T3 or you're over-medicated on thyroid medication, which I also see. So yeah, I mean, that's sometimes tricky, but I think I think bottom line is like get on the right dose of thyroid medication. Check your labs. If you ever change your thyroid medication, you need to check your labs six weeks later. Make sure your TSH 3T4, 3T3 are in a good range. And then with hormones, yeah, it's like all over the map, right? Like women early on have this like often estrogen dominance symptoms and heavy painful periods. And then, you know, in parimenopause, start having more irregular periods or maybe they're closer together and they're having hot flashes and vaginal dryness and UTIs. And I think we just have to kind figure that one out probably with your doctor. Like an OBGYN is pretty many are pretty skilled these days and in hormones. Maybe I'm just jaded because I work with like more integrative OBGYS. You know, and I think the other piece is like educate yourself as much as you can so that you can advocate for yourself when you go see the doctor. Yes. Like, yeah, can't just, doctors have told me things where I'm like, yeah, that's ridiculous. I'm not doing that. Like, right. You know, I mean, they don't have a much time. 10, 15 minutes with you is not enough time to like figure everything out. So I really think like when I drop my car off at the mechanic, I don't know what's going on there. Like, I just sort of trust what they tell me. But I don't think you can do the same thing with your healthcare. I think listening to podcasts like yours is super important. Like educating yourself and knowing that finding some of you trust, you know, like ultimately the other side of that coin is sometimes we have patients who literally question every single thing. And it's like, at the end of the day, I think you do have to find somebody who you trust and has expertise in this area. But just, you know, you don't have to accept everything. Like, it's your body, you know, it best. Make sure you're working with somebody who takes that input. Yeah. Good advice from a doctor. So, I love that. So from Marley, and this is kind of a common theme for our next question too. But she says, are there signs that someone will see when it's time to reduce their thyroid meds? Totally. Palpitations, trouble sleeping, feeling jittery, kind of like you drink too much coffee in the morning. Maybe fast heart rate, you might see that, especially like I wear an aura ring. So, you know, that can maybe indicate it. Sometimes people aren't super symptomatic and sometimes people are super like sensitive and have a lot of anxiety. So I have one patient who comes to mind. She came to me after seeing somebody who's more integrative and like, you know, the thyroid specialist. And she was on way too much medication. Like her free T3, I measured her free T3 after she took her medicated. I could could have looked at the doses and said, like, this is too high.
like I can already tell you you're you know a lot of your anxiety which was debilitating by the way like she can even leave her house you know so we looked at labs like let's prove it first labs are super helpful and we saw that her free t3 was like 4.8 or something like it was way too high and so just you know progressively we just shaved back like little by little by little I don't want to like cold turkey like okay let's cut your medication in half I just like to reduce it slowly and so you know we've got her to a point where she's great like her free t4 all those those like lab optimal values I mentioned earlier she's there now and she's doing awesome sometimes like she was very thin so sometimes people will experience weight loss but that's not like a huge symptom I think it's more like the anxiety and they can't sleep and they just feel like almost like this extra sense of nervous system dysfunction when you're taking basically like more of a stimulant so most of those symptoms I'm talking about happen more often with people who are on a natural desiccated thyroid like armor which contains t3 or taking side amel which is a t3 medication so if you're just on a t4 medication patients tend to have less symptoms so it's just like it's get back to labs like reduce your dose when your labs are abnormal I'm not one of those doctors who likes to suppress tsh because there are a lot of people in my community who not a lot but they're definitely people practitioners who prefer or suppress tsh in a high t4 and t3 and I don't I think that goes back to the risk benefit piece where it's like well then we've got the risks associated with thyroid medication which we're not looking for so yeah this is a really interesting question from Farah and it brings up a popular topic which is carbs low carb and thyroid she says I've had Hashimoto's for years I'm 48 since January I've very been focused very focused on balancing my blood sugar and have been low carb in the process I've lost 50 pounds I had my thyroid checked in April tsh was 3.5 much higher than I'd like I asked to increase my meds what she did she said she went from 105 micrograms to 138 I just had it checked again did I say that right micrograms yeah yeah yeah yeah I just had it checked again in October and my tsh was 4.4 my questions do I just keep increasing my medications there's there's something else I can work on my doctor will only run t4 and tsh and it was 1.57 my second question is can there be too much medication it seems like a lot right now yes there's two here could be two which we just talked about I think when she says my doctor will only run t4 with tsh and it was 1.57 I think she means her free t4 is 1.57 and it depends if if she took her medication like right before the blood draw which is often what people do because they take their medication first thing the morning go to the lab then it it might look artificially elevated but it sounds like the free t4 level is really good I would be real curious about her free t3 and if she might benefit from side of my I would also I'm you know the reason for her tsh going up is pretty atypical usually as you lose weight you need less of a dose when we start with dosing there's a calculation where you just calculate sort of weight like ideal body weight in kilograms times 1.6 is like a good starting dose for t4 for some people I don't always do that but but yeah I mean as you lose weight typically we see that you need less thyroid medicine I wonder in her case if she's converting more to reverse t3 and if she's hypochaloric her body is getting into the state of like survival so I always say this is why I check reverse t3 it's like you've got free t4 and it goes to free t3 and reverse t3 free t3s or gas reverse t3s or breaks if your body is in a state where it's like oh I got to survive and preserve my resources because I don't have enough food and I'm in my cave and I can't find food or I broke my leg or trauma, toxic infection, all that kind of stuff in your body's like ooh just survive slow that metabolism down let's make a bunch of reverse t3 maybe she's low free t3 and maybe she needs more calories I don't know I mean I don't it doesn't necessarily mean she needs more carbs I think the weight loss piece is great and important for you know insulin resistance and things like that but that would be my my investigation with her. So low carb is in this you don't think that low carb is necessarily bad for good or bad for the thyroid it just depends on the situation and also the caloric intake. Yeah, accurate and I think it really depends on blood sugar so like maybe if she's exercising like maybe she's overexercising and not replacing what she uses so in days when she works out more she probably needs more carbs but it's like squash potatoes, carrots, beets, starches, kind of stuff maybe I don't typically recommend like quinoa and grains for patients but like some people do okay with it and if you are super active like you do have to replace what you use or your body is like in a state of oh I got to survive so this is where I really like to use a glucometer especially for patients who struggle with weight and make sure that blood sugar truly is in balance there's no hypoglycemia, sleep is good like what else is going on if she's not sleeping very well I would definitely think like oh you probably need more carbs because you could be going hypoglycemic overnight and increasing your cortisol and then you're waking up at night like maybe that's a piece of this puzzle but nothing's easy right like like Pharaoh what's an easy answer for you check your free t3 maybe you need side of a well at your say other thing I like to get more than one data point maybe the day that you had your tsh check you slept like crap and had a really stressful week and watched too much news so maybe just check another set of labs ask for a free t3 if your doctor won't do it you can just go get it done yourself through quest I appreciate you trying to always find an easy answer I mean it just isn't easy if it were easy everybody would figure it out you know yeah it's great complex like I think we always are looking for easy answers like eggs cause high cholesterol well it's not that easy dietary cholesterol doesn't give us high cholesterol it's just like things don't translate like that we're complex beings yes yes another complex question this is from Andrea she's actually five months months postpartum I know you do a lot of work with pregnancy and postpartum moms she says she's been having gallbladder attacks since two months postpartum I've gallstones and sludge but my skin show that it's still functioning well the trigger seems to be constipation when I miss one day of going I get an attack I've done a ton of support for my gut gallbladder and liver and the attacks have gotten less painful but they still happen she says she does have hypothyroidism her levels are currently optimal she's breastfeeding drinking plenty of water and electrolyte she eats enough protein healthy fats carbs I'm exercising she's in a pelvic floor PT I've been on top of everything can't figure out the constipation and my providers can't either wondering if you have any ideas of possible causes I got my first postpartum period at six weeks and tested positive on my LH trips for ovulation constipation doesn't seem to be happening at a particular point in her cycle okay so I'm hoping she's using magnesium and she mentioned electrolytes and drinking lots of water which is super important when you're breastfeeding the one thing she didn't mention is colean so colean or phosphatol colean is the premier component of bile something that gets depleted during pregnancy and breastfeeding the recommended requirement of colean during pregnancy and breastfeeding is 450 plus milligrams per day most prenatals have no colean or like 50 milligrams of colean like nothing so primarily from a dietary source we get colean from egg yolk but I would try if she's not already supplement with phosphatol colean and I go you know pretty decent dose you don't have to like overdo it but maybe like 415 900 milligrams and like that and see if that helps at all maybe bitters so one of the most common I think the second most common surgical indication in pregnancy outside of c-section is colicisectomy which is getting your gallbladder out so this is not really we're not alone yeah you're not alone this is very common and I think the root of it has to do with the colean issue at least in part and so some of my favorite supplements in pregnancy are colean and bitters so I use a lot of bitters the quick silver scientific bitters is great super low risk too like it's probably not gonna hurt there's lots of supplements too like seeking health has one called gallbladder nutrients that you could try but I would really focus on that kind of stuff like milk thistle colean bitters and see how that goes try and think if there's anything else she said I mean hormones like might play a role but the magnesium piece should do it the other thing you could test for is methane predominant sebo so constipation especially when accompanied by blood and gas bilching can be a sign of methane predominant sebo perhaps she had antibiotics in pregnancy for uti or at delivery some like that maybe it checked or like changed her got microbiome yeah oh that's the sebo breath test on her right and then give her all those supplements yeah I forgot that so many women especially if you're strapped positive you end up with antibiotics in during delivery and that can really throw you off
Yeah. Okay, this is from Stephanie. She says, "I've been on a steady dose of levo thiroxine for about six years each time "I've gone at checked in the last two years. "I've been churning more towards the normal to low end "around 1.4. "I'm wondering if it's ever possible to ween off medication. "Is there a case for wanting to ween? "I've never had a doctor talk to me "about wanting to move me off of the medication. "So I'm wondering if it's even an option "or should I plan to be on the meds for the rest of my life." It depends on why you have thyroid dysfunction in the first place. If it's Hashimoto's and if it's been going on for a long time, that would indicate that there's been some autoimmune destruction of your thyroid gland, and you probably do need hormone support for the rest of your life. And I hate to say that, but I don't like taking iodine is not going to make your thyroid magically like start pumping out thyroid hormone. Often what I've seen clinically is like, when we start treating patients for the right things, which is complicated, we can start to reduce the dose, but there's not that many patients that can just straight up get off medication, especially if they were frankly hypothyroid to begin with, meaning like their TSH was above five or 10 when they started thyroid medication. So sometimes I see people do this, and they'll just like, I don't wanna take thyroid meds, and then the TSH will be like 50 or something, you know? So I think there's a case for reducing medication or being on the lowest effective, well, not the lowest effective dose, 'cause I am more advocate for being on the optimal dose, that makes you feel the best. So, but I think just making sure like you're giving your body all the other things it needs to make your thyroid hormone as best you can, and then supplementing with what's needed. But I don't know enough about her to know of getting off of medication is an option, but I would say like, probably not. - Yeah. Okay, I got a couple of questions about hormones to round us out, this is from Kayla, she says, what are the biggest things to focus on when balancing hormones, specifically balancing estrogen and progesterone, she has estrogen dominance and low progesterone, which is probably, in my opinion, one of the most common hormone dysfun- or in balance. - Yeah, she's coming, yeah. So I think proper elimination and liver function is important, I mean, there's all sorts of supplements we can use for estrogen dominance and low progesterone, like dim and chase tree, it uses a lot, but I think really supporting your elimination pathway. So liver, gallbladder, gut, you have to poop out your estrogen every day if you're constipated, start there, poop every day. Also blood sugar, so stable blood sugar is super important and cortisol, so exercise, but not too much, eat well, but not too much, all that kind of stuff, it's like, it just, it really does go back to everything in moderation to some degree, except for gluten, as you've heard me say a couple times, people with thyroid disease, I'm not like, no gluten in moderation, like most people need to be on a gluten-free diet, but not everybody. So I think proper sleep, 'cause that's gonna affect cortisol, good nutrition, really focused on blood sugar balance, healthy fats, liver, gallbladder, gut health, pooping every day, I think those are the biggest ones. And then, like I was saying, for estrogen dominance and low progesterone, I do tend to use dim, but not like a superhydose. But yeah, I liked dim and I like chast tree and, yes, yeah, and all three carbonyl and some of those. - Yeah, I think we can't, I just got actually got a DM yesterday from somebody, she had messaged me and said, I'm getting these horrible menstrual headaches and I just don't know what to do. And I said, if you're not taking magnesium, start taking magnesium and then, you know, look into some of, I had written some articles just about, you know, how to naturally support hormone function. And really the main things in those articles are like support estrogen detoxification, each year leafy greens and, - Yeah, yeah, totally. - You know, I totally, yeah. - During mid-site, especially mid-cycle, yeah, 'cause her headache started, right at ovulation and would go to, when she started her period. And just making those, she just messaged me and she, just making those little tweaks of like, okay, I was really intentional about leafy greens and he mired and all that kind of stuff and eating that and really supporting estrogen detoxification and taking my magnesium. And like, I didn't, for the first time in years, I didn't have a, my, like, a menstrual migraine. - Yeah. - And so I think sometimes we, those little things can make such a big difference. - They can. - They can. - Yeah. And it's like, if you don't really know that you have estrogen dominance, but you just think it's estrogen dominance, like start with crucifurus festivals. - Right. - That's gonna help. That is dim, like, that's where we get dim from, right? - Right. - So, right. I don't, I, I am weary about people who don't know what their labs look like using dim, kind of indiscriminately, because you don't wanna deplete your estrogen 'cause then you have this whole other problem and then you don't have, - Right. - Like, you know, so I wouldn't, especially if you don't know what your labs look like, I wouldn't be super aggressive about that sort of stuff and dosing, but yeah, I think those are great points you made. - McKayla also asks top tips for getting rid of horrible menstrual cramps. - Magnesium. - Magnesium. - Magnesium's probably my favorite. - Things like curcumin and fissioil can help too, just kind of anti-inflammatory. - Do you recommend vitax, like, people cycle it in or take it daily or? - Most of the time I just have them take it daily. Yeah, taste your your vitax just daily. I mean, it depends on the patient, you know, but most of them, I'll just have them use it daily. So that could help and castor oil packs can be helpful. And then all the stuff to help with estrogen dominance, if that's the cause of the horrible menstrual cramps, which I always say, like those comments, not normal. - Yeah, right. Last question is from Elizabeth. She says, "Do you have any information on ovarian cysts and how it impacts fertility? How do I manage the pain? How much digestive systems can actually be attributed to them, for example, bloating and gas?" I was recently diagnosed with three on one over and two on the other waiting to get into an OB to talk about options. - Mm-hmm. So this makes me wonder about PCOS. If somebody has polycystic ovarian syndrome, often it's, there's like a big blood sugar component there. It can be a kind of loaded one. I would definitely make sure they're testing your testosterone levels as well. This is always a tricky thing when you get, like when you're a conventional doctor. So often what happens is OB/GYN, there's like pelvic pain in OB/GYNs, like it's not because of an OB/GYN issue, like it's not your uterus or your ovaries. So go see gastroenterologist. And then you see the gastroenterologist and they say, "Well, I don't think this is because of your colon or gastrointestinal issue. I think you should go see OB/GYN." So there's definitely crossover there. And we don't always know. I mean, if you have both digestive symptoms and ovarian cysts, it could just be that maybe you have a gut infection and you also have PCOS. And they're probably connected in some way. I mean, there is a higher correlation between people of PCOS and Hashimoto's. I don't think we necessarily know why, but it definitely is, I think people with Hashimoto's are three times more like at PCOS, don't quote me on that. So the ovarian cyst piece, like if it is polycystic ovarian syndrome, the diagnosis there is based on polycystic ovaries, elevated androgens, like testosterone or DHA, and then and/or signs of heursitism. So if there's like dark hair, acne, and I'm saying like dark hair in your upper lip, like places you don't really want it. And irregular periods, does she have irregular periods? Did she say that? - I don't have that information, but she just wanted to know how it impacted fertility. - Yeah, so if PCOS is a thing, it definitely impacts fertility. It doesn't make it impossible to get pregnant, but it is a very common cause associated with infertile and fertility issues. Outside of that, I don't know why else she would have ovarian cysts. - Yeah, I think that's pretty insightful actually. And you're, sorry, this is kind of an intense follow-up question, but with PCOS, what are some of the initial changes that you're recommending somebody make? Is it all, I mean, I hear so much about insensitivity and blood sugar with PCOS. I mean, is it that simple? Like what are your red flags, I guess? - Sometimes it's that simple. I mean, you know, eating regular meals, probably lower carb following your blood sugar. And then if you have high testosterone, I'll often use interventions to get rid of that, but like exercise is also a really big one that goes hand in hand with the blood sugar piece. So PCOS is pretty darn common. It's actually like crazy common. So there's a ton of supplements you can use with PCOS that are helpful, just kind of depends. Like if you do have high testosterone, I'll use medication, or not medication, but I'll use supplements to help bring it down. I do think like my big platform is don't use birth control to treat PCOS because it does not treat PCOS. It gives you a fake period so that your PCOS festers and then you have to like figure out how to treat it 10 years later when you go off of birth control. And do you want to actually get a handle on your hormones? So also with PCOS, like track your periods. So many women, I'm surprised, don't track their cycles. They're like, I come every three or four weeks or something like that. So keep track of the days. What's really helpful as from a clinician standpoint is like day one of your cycle, count from there to the next day one of your cycle. 28 to 32 days is really ideal. If your periods are sometimes 25 days and sometimes 38 days, we've got issues. Like we should be addressing that. Yeah. If it's like off once in a while, it's usually not the big of a deal, but like tracking trends, your hormones tell us a lot. So pay attention to your period. I love that. Thank you, Dr. Marin, for answering all the questions.
We got through all of them. I'm so excited. Like, are we gonna do it? We did it. I know a lot of people are probably like, "Can I just work with you?" Talk to me about your virtual practice and how people can actually get in touch with you. - Yeah, so I see patients in Colorado, Michigan, and Texas because of licensing laws, we can't see patients all over the country. Eventually that might catch up, right? Let's hope. But for now, Colorado, Michigan, Texas, those are the states where I'm licensed. And you can learn all about my practice on my website, which is drkristinemarin.com. - Marin is M-A-R-E-N. You also have a free 12-way SDTACS, your home, a one-year plan to creating a healthier household. That's a totally free e-book at stuctorkristinemarin.com/gift. We will link to that in the show notes. Also follow her on Instagram. It's @Drkristinemarin. Very simple and straightforward. Thank you so much for being here. And I would love to have you back. I think you need to write a book. This is what I would say to all my guests. But I think you need to write a book because, man, 2023, in dealing with thyroid issues is different than how we dealt with them 10 years ago. - Yeah, it really is. - Yeah. - Thanks for having me. Thank you. Yeah, for more from drkristinemarin.com. For more from me, coconutzandkettabels.com. Thanks for being here, guys. I will talk to you next week. (upbeat music) (claps)
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