676: Thyroid Health, Metabolism, Hormones, and How to Improve Them With Dr. Amie Hornaman

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Katie: Hello, and welcome to The Wellness Mama Podcast. I’m Katie from wellnessmama.com, and this episode is all about thyroid health, metabolism, hormones, and how to improve all of those with Dr. Amie Hornaman, who is a fascinating guest. She is known as The Thyroid Fixxr and she hosts the top rated podcast in medicine and alternative health called The Thyroid Fixxr. She’s the founder of the Institute of Thyroid and Hormone Optimization, an organization with transformational proven approaches to address thyroid dysfunction and support people in returning to full health. She’s also the creator of the Fixer supplement line with revolutionary proprietary supplements that are changing the lives of people all over the world. And ultimately, she’s on a mission to help thyroid patients around the world get their lives back. She’s also competed in both bodybuilding and weightlifting and set a state record at the age of 34, which we talk about here.

In this episode, we go deep on the way that our thyroids are connected to metabolism, hormones, and so much more, the symptoms of thyroid issues and what about what happens when the labs disagree with the symptoms? We talk about TSH, what lab tests to get to get an accurate picture, about free T3, about testosterone, which is the most abundant hormone in a woman’s body as well, and why this is important and natural ways to get all of these hormones back into better levels. Talk about symptoms of low progesterone and what to do about it, how insulin comes into play, more reasons why magnesium is important, especially for thyroid, and so much more. Very fact packed episode. So let’s join Dr. Amie. Dr. Amie, welcome. Thanks so much for being here.

Amie: Hi, Katie. It’s my pleasure. Thanks for having me.

Katie: Well, I’m excited to learn from you today and I have a feeling our topic is going to be really relevant to a lot of people listening, specifically when we go deep on thyroid health. But before we jump into that, I have a note from your bio that you broke a state weightlifting record at the age of 34. And I’m also in my thirty’s and have just gotten into lifting heavy in the last few years. And so this is like selfishly, I want to hear this story.

Amie: Yes. So I’ll try to make it brief, but I went from competing in bodybuilding and fitness and figure where it’s very subjective, you have to diet down and stand on stage in a bikini and all of that. And when I retired from there, I’m like, you know what, it’s going to go lift heavy. So my coach got me into power lifting and that’s very objective. It’s like you either lift that weight or you don’t. And I just love deadlifting. It just felt so as a woman, just so powerful and you feel strong and yeah, that weight either comes off the ground or it doesn’t. Right? And I went into this competition, I got a couple under my belt by now and went into this one particular competition where I looked at the state records for my weight class. I’m like, that’s going to be a new PR, personal record, but I think I can do it. And I did the whole visualization, I did everything leading up to that and there it was, pulled it, held it, bam. New world, new state record. So it was pretty amazing. One of the best times in my life. I can say.

Katie: I love that. That was really instrumental for me actually, as well. So a lot of the listeners know I had thyroid issues in the past and now have they’ve all resolved. But one of the mindset pieces that was really pivotal for me was learning how to have a better relationship with my body and to nourish it versus deprive it. And also to focus on instead of the number on the scale, I started focusing on the number I could pick off the ground and ironically, the number on the scale finally started going where I wanted it to when I stopped fixating on it. And I think there’s so much of that like the mindset piece that comes into this. And I know that you have very specific, helpful knowledge, especially when it comes to thyroid health, but also how that overlaps into metabolism and hormones in every area of health. So maybe to start broad and foundational, if you can just walk us through for people who aren’t familiar, maybe some of the background of just how intricately our thyroid affects so many other things in our body.

Amie: Oh, definitely. So we have to remember, the thyroid is the master gland. It is the master gland controlling the show in your body, from your metabolism to your skin turnover rate of the cells of your skin, your hair growth, your energy, ATP production at the mitochondria level. It really does control the body every organ and system. And it’s actually a shame that we don’t look at the thyroid more in conventional medicine. And I know we’ll go down that rabbit hole eventually, but you just have to mention it now. It’s a shame that it’s not focused on to a greater extent, since it does control so much.

So when your thyroid is off, whether you’re diagnosed hypothyroidism, autoimmune Hashimoto’s, or it’s just not quite functioning very well, it’s in that subclinical state where the numbers are starting to shift, but you certainly have all the symptoms to go along with it. That’s where we really have to focus on it, because then downstream from that are all of the systems that start to go haywire. Our sex hormones go wacky, you start to lose control over your glucose regulation, your blood sugar, you become constipated. So now you think it’s a gut issue, but it’s your thyroid. Your doctor gives you an antidepressant, but hey, it’s not a prozac deficiency, it’s your thyroid. So all of these other systems become affected and that’s where people do get the bandaid. If we go back to the master gland and focus on that, we can make such a huge impact in a person’s body and in their life and how they feel on a day-to-day basis.

Katie: Yeah, and I’m excited to jump into your whole body approach for actually addressing that, rather than kind of spot treating, which seems like the more conventional method that happens. I would guess a lot of people listening might have had a similar experience that I did, where I was noticing symptoms. I did my own research and realized it’s probably thyroid related, but I wasn’t getting good answers from my doctor and it didn’t feel like the testing was actually evaluating the whole range of what was going on. But so starting broad from there, what are some symptoms that people might notice if their thyroid is a little out of whack? And do those always line up with the lab testing?

Amie: So the big symptoms that we always hear right off the bat, it’s going to be your weight gain and inability to lose weight. So these are the people that they’re doing it, all right? They’re really trying. They’ve read every diet book under the sun, they’ve taken every supplement, they’re on every Facebook group trying to get information. And no matter what they do, that scale is not moving or it’s going up. So the weight gain, just inability to lose weight, can’t control that.

Next up would be fatigue. And it’s that crushing fatigue. It’s where you’re looking at your couch at two in the afternoon, you’re like, wow, that really looks good over there. I could definitely take a nap, even if you got a great night’s sleep the night before. But then, of course, there’s the insomnia component, which also goes hand-in-hand with thyroid and constipation, hair loss, joint pain, muscle pain, depression, anxiety. I mean, the list goes on. But those are the big ones. Those are the ones that I hear pretty much every single day. And then we can kind of get into the more intricate ones where people will ask me, well, I have a ton of allergies. Well, yes, if you have Hashimoto’s, that brings on an elevated histamine reaction. So you can have more allergies than your neighbor who is exactly the same age and weight and height as you, but you have a thyroid problem and she doesn’t, so you get more of these symptoms showing up.

Katie: That makes sense. And I’ve seen this kind of play out in the meme world on social media with the jokes about, like, a woman gets on the scale and she looks disappointed. She gets off. She takes off her clothes, takes out her contacts, washes her, like, every possible thing she can take off, and she gets back on the scale and she’s like, it went up. And I think that a lot of women have maybe experienced that where you feel like you’re doing all the things right. And I think that’s actually a wonderful thing because that means it can be an insight of why your body’s not responding. Like, I’m a big believer that our body is always on our side. So in those cases, it’s not that our body is betraying us, it’s trying to tell us something. And that was certainly true in my case. You also touched on a little bit, but thyroid health, lining up with skin and hair health. And it seems like for women especially, this is a big symptom that a lot of people get really frustrated with because it’s so visible.

Amie: It’s huge. And I will have women literally telling me the amount of hairs that they take out of their brush or that they are holding in their hand after they get out of the shower. And it’s devastating. I mean, to us women, our hair is our crown, right? So when we start to lose it and again, it’s out of our control, it just starts to happen and we’re like, what is going on? So we do all the things of going to the dermatologist and we check with our doctor, maybe we buy some Rogaine at the drugstore. And we’re trying that and it really starts to impact our self esteem. And the skin part I don’t see as much, but really dry skin is a factor in hypothyroidism because you don’t get that cell turnover rate happening like it should be. So we’ll get the really dry, flaky skin, but the hair Katie, oh my gosh, that’s top of woman’s list. It can actually be the number one symptom in some of my patients because they’re so hyper focused on it and they’re just really mentally bothered by it.

Katie: Yeah, for sure, because it is so visible to everyone they interact with. And like I said, for me, at least, my story, it was hard to actually get accurate testing, especially when I was trying to just go the conventional medicine route. And I’m grateful because I learned so much through that experience and through working with many different doctors before finally getting answers. But it seems like there are some kind of misconceptions/major problems when it comes to thyroid testing in the conventional world, where for me, they weren’t testing all of the related thyroid hormones. They would test one or two and they would define them as normal, which I think is a potentially another problem because those are based on sort of lab average ranges that might not reflect optimal. But can you walk us through the intricacies of testing, what we should test for and why sometimes testing may not seem to reflect what’s actually going on in the body.

Amie: Right, exactly. Oh, I can’t wait to have you on my podcast. We’re going to get deep into your story, girl. But, yeah, no, the testing. Oh, that’s huge. It’s just huge because that’s something I see every day, too. So patients will come in and they’ve gone to their doctor and they ask for a full thyroid panel because they heard people talking on a podcast about this thyroid thing, right. And it’s super important. So they’ll go in and they’ll say, hey, Doc, can I have a full thyroid panel?

Well, you might be lucky if you get a free T4, you’re definitely going to get a TSH. Let me break those two down. TSH is thyroid stimulating hormone. It is a pituitary hormone. It is not a thyroid hormone. So it’s a messenger from your brain to stimulate the thyroid gland to produce more thyroid hormone, T4 and T3, that will go up. So TSH will increase when your thyroid production decreases. So that’s the only kind of inverse test that we see. TSH goes up as your thyroid function goes down because it’s basically the pituitary yelling at the thyroid. It’s like when your kids are bad and you’re like, Johnny, pick up your toys. And then Johnny doesn’t do that, so your voice goes up a little bit. Johnny, pick your toys up. Let’s go. That’s TSH rising in response to low thyroid.

Now, that may or may not tell us something. I have seen hypothyroidism in women, in people, but mostly women, where that TSH is perfect. It’s actually in the functional optimal range. So we like in functional medicine, we like that TSH to be below a two. Now, that standard lab value range that is huge, vast and wide will go all the way up to a 4.5. We like it below a two if it starts to creep above a two. We go, there’s something going on here. We definitely need to look deeper, but I have seen TSH below a two. But then we move on to the other markers and we pair it up with the person’s symptoms because you are more than a lab value. And then we get to see the whole picture.

So then we move to that free T4, which you might get. You might get that one. And T4 is the inactive thyroid hormone. So it’s great to have that free T4 test, free, meaning unbound. We want to check what is available for the cell and in the case of T4, what is available to be converted over into the active thyroid hormone T3. So we test free T3. Now, there’s one of the important markers, that is the active thyroid hormone. I want to know how much active thyroid hormone is actually in your body, ready to be taken up by the cell, ready to attach to the receptor site on the cell to do its job, whether it’s to give you a metabolism, to grow your hair, to let you poop every day. Whatever it is, that T3 has to attach to the receptor site. I want to know how much active thyroid hormone you have. That’s important.

Moving on from that, we have reverse T3, which is the anti-thyroid hormone, and reverse T3 will block T3 from getting to the cell to do its job. So I always use the analogy here of a bouncer. It’s a bouncer outside the club, arms crossed, telling T3 can’t get in. You’re not getting in tonight. Sorry. Because if that reverse T3 is elevated, it’s literally putting your body into a survival state and it’s blocking T3 from getting to the cell. So what that means for you? No metabolism, you’re not going to feel well, your energy in the toilet, you’re going to lose your hair and you’re not going to poop every day.

And then we want to move on to the TPO and the TGA antibodies. And that’s what tests for Hashimoto’s. Now, 95% of all hypothyroidism is Hashimoto’s. It’s the autoimmune form, Hashimoto’s. And that’s why it attacks women more than men. That’s why I tend to lump women into thyroid talk, because it affects us more. We have more autoimmune. When we’re looking at TPO and TGA, we’re looking for any kind of antibody that is present. You don’t have to be flagged, you don’t have to get an H next to it. If there are any antibodies present, that tells me that you are starting to build up these soldiers in your body that like to go out and they attack your thyroid because they think your thyroid is a bad guy. And I don’t care if there’s five soldiers or 500 soldiers, I don’t want them there. I don’t want those soldiers going out and attacking your thyroid gland, because if I come in and beat you up every day, you’re not going to do your job very well. Well, the thyroid gland can’t do its job very well if it gets beaten up every day, if it’s always in a war.

So we want to look at how many antibodies you have, look to see if this is a case of Hashimoto’s, and then address those as we’re addressing everything else, as we’re addressing the low thyroid hormones and all the other markers that we’re looking at.

Katie: That makes sense. And you mentioned that you mainly think of women when it comes to thyroid issues, and it certainly seems like women are primarily affected, although men can be. But why are women affected much more often, especially by the autoimmune forms?

Amie: Because we have less testosterone. So testosterone is the most abundant hormone in a woman’s body. I don’t know if you knew that or not, but it is. But men just have more of it. So when we’re looking at our total levels of testosterone, men have more testosterone. And testosterone is very autoimmune protective. So it will actually protect a person from that autoimmune light switch, from turning into the on position. Really, that’s why I am so passionate about optimizing sex hormone levels, too, in a woman, specifically testosterone, because then that will help protect her from autoimmune. It will help calm down Hashimoto’s if she has it already, and it will prevent other autoimmune conditions from popping up. Because we know with autoimmune, where we see one, we normally do see more than one. So it really is a big testosterone is a big component.

And then just us as women, we go through so much more. So pregnancy very natural, something you might want to do, but it’s a stressor. It’s a huge stressor on the body. And Katie, I don’t know when your thyroid problems popped-up, but I hear a lot of women, I’m sure your audience can nod with this one. A lot of women, they go, it was after my first child. It was after my second child that it just all went to hell in a handbasket. And that’s when all my symptoms started. And it’s like, yeah, that’s when your autoimmune switch went boop and it turned on. Because pregnancy is a stressor, albeit a good one, it’s still a stressor. And that’s really all that the body needs to flip that autoimmune switch. And let’s face it, men don’t go through as much as we do. So there’s that.

Katie: Yes. For me, it was after my first son was born. And the frustrating part was, I was told by doctors at the time when I brought up like, hey, these things are happening, they were like, oh, that’s normal. That’s postpartum, that’s just like, basically get used to it. That’s life now. And I’m glad that I kept looking for answers and discovered that there were much better answers than those. But it’s an experience I hear very commonly from women, and it makes sense because we have so much more variation happening. But I do feel like the testosterone piece is likely new information for a lot of people. And potentially, I know this can be a little bit of a controversial topic, but you mentioned keeping hormones in range and I’d love to hear more about how you do that with women especially. Do you recommend hormone replacement? Are there other ways they can naturally kind of bolster their testosterone? I think it probably is new information for a lot of people listening that testosterone is actually the most abundant female hormone as well.

Amie: Yes, testosterone. So I call it the GSD hormone that gets stuff done hormone. And that is what really allows us to do so much, because we tend to have this stigma around testosterone, where we think of it as a dude hormone and we think of it as something that’s going to make us big and bulky, like a bodybuilder. And that’s simply not the case. We have to look at testosterone for really all the different roles it plays in the body from, yes, motivation and the ability to build lean, sexy muscle mass, which makes you more metabolically active. Yes, it definitely helps with losing fat and your metabolism, but it helps your brain, it helps you focus and concentrate and actually be motivated to get things done during the day. It helps protect your heart. It’s very cardio protective. It helps balance insulin and insulin resistance. It helps with lipids, it helps with just overall mood, sexual function, whether it’s a man or a woman. Yes, ladies, it helps with our libido too. And like we said, it’s very protective against autoimmune. So when we’re looking at hormone replacement, it really depends on the age of the woman, where she is in life, in her cycles. Is she perimenopausal, menopausal? Is she still having babies? Like still in her 30s? Going to have a couple more kids? So it all kind of depends on the individual. Now, we will see progesterone start to tank. I mean, we could see that in teens and 20’s with something like PCOS, so we can see low progesterone early on. And yes, absolutely, we can use bioidentical hormone replacement to replace progesterone in whatever age. In fact, progesterone is better than throwing a birth control at a 20 year old because she has heavy periods. Let’s give her real progesterone, right?

And then estradiol. Estrogen, estradiol. That usually comes in. Always bioidentical, that will usually come in more so in the latter part of a woman’s life when she is in perimenopause and menopause, when we really start to see that FSH climb and estradiol start to tank, and that’s where estradiol replacement will come in. Testosterone is another one that can come in at any point of time. Now, there are studies that show that adequate testosterone levels are vital for a healthy pregnancy, vital for fertility. So we may even use a little bit of testosterone when a woman is trying to get pregnant or if she’s struggling to get pregnant, and then we can pull it as soon as she does get pregnant, just so no androgenic side effects start to happen with the baby and the development of the fetus. And that’s all monitored and tracked. And it’s a little bit more rare that we use it during a woman’s life in that point of time. But we will definitely forty’s, fifty’s, sixty’s, seventy’s.

All the way above that’s when we really see low testosterone levels and I look at the total testosterone first in a blood test, I will also test the free testosterone. But that total is vital. That total, you want above a 50. Now you will be called normal, and you will fall into that normal reference range. If you’re rolling in with a testosterone of a 15, you are not going to feel normal, you’re not going to feel good. You’re going to come to me with all those same symptoms. I can’t build muscle. I’m at the gym and I’m lifted. I feel like I’m losing muscle. I feel weak, I’m not motivated. I can’t get through my day. I’m putting on weight and, oh, yeah, I have no libido whatsoever. I can’t focus on anything during the day. Yeah, because your testosterone is a 15. So when we get that total up, the free will normally come with it. There’s a couple of other markers that we look at as well. Then that can change an entire woman’s life. Men, definitely men. You need your testosterone at a whole different level. We’re talking 800 to 1100, but that’s not what we’re talking about here. Women, your lives will be changed when your testosterone is optimized, and that is also going to have a feedback back to the thyroid and it will help to optimize the thyroid gland as well.

Katie: That makes sense. And to echo your point, I know that is a concern for a lot of women, that they don’t want to get bulky and they don’t want too much testosterone. And now having sort of been on that journey of trying to get stronger for the last three years and having gotten a whole lot stronger, it’s laughable to me that I used to worry about getting too bulky by accident. Now seeing how hard I work, and I got bigger when I started doing that. So I’m now a major proponent of women lifting heavy things and building skeletal muscle, which is also, I think Dr. Gabrielle Lyon calls it the muscle of longevity. So the more muscle statistically, the healthier you are going into every decade of life.

But I think the other side effect of this, because thyroid can lead to weight gain, is that often women will start dieting and over dieting. And this was the case for me, which is also a negative feedback loop for things like testosterone, but I was also just massively undernourishing myself, which was further stressing my thyroid. But I know it also feels scary to eat enough food when you feel like you can’t lose weight to begin with. So how do you address that with your patients? Because I will say from my own anecdotal experience, once I started addressing everything and I actually started eating more and especially more protein and more micronutrients, I actually started losing weight more easily, likely because I wasn’t in fight or flight like survival mode the entire time from starvation, possibly. But how do you address that with your patients?

Amie: Very similar to Gabrielle, I had the whole theory of protein first. Protein first. And as you know, we see so many women just not getting in enough protein, although they think they are, and then we sit and we total up what they’re actually eating in a day, and they maybe hit 50, 60 grams of protein. So I just go through the deep explanation with all of my clients that, listen, you have enough protein here for your heart to beat, but what are you going to feed your muscles? Oh, wait, how about your hair? That’s amino acids too. So how are we going to actually get in enough protein so that your muscles are fed after you do go and work out, because you’re working out like crazy trying to lose this weight, right? How are we going to feed those starving muscles so that they can take up those amino acids and they can produce new lean muscle tissue that’s going to then give you a better metabolism?

And it really is just about education and it’s about them implementing it. And just like you, Katie, seeing the results now, part of this, and I say this all the time as well, it doesn’t matter how much protein you eat, how much dieting you do, how much you lift heavy, if your thyroid isn’t optimized, because then you’re going to be in an R-boat. Because I was in the same boat as you, doing all the things, like all the things and nothing was working. But it was my thyroid. It was the thyroid that was off. Once you optimize that, then everything else you do starts to work. Then you get bang for your buck, for your efforts that you’re putting in at the gym and in the kitchen and buying all the right things and making all the right things, because now you have a metabolism. So it all has to work together.

Yes, we have to educate on the protein component. We have to be fixing the thyroid over here, too, so that then when the woman starts increasing her protein like you did, now you’re starting to see, oh, my gosh, my body comp is changing, I’m getting tighter. Maybe don’t even look the scale, but my body is changing, I’m getting tighter, I feel stronger. Like I’m seeing these curves coming out at the gym, and there’s your reward to just keep going.

Katie: Yeah, it makes sense. And just a tip from my personal experience in the intensive healing phase for my thyroid, I actually took a break from all intense exercise, and I just focused on walking and gentle swimming and recovery and rest for a while. And I felt like my body needed that restorative time. And then now I focus on I don’t do any long form cardio, but I do sprints and weightlifting because I feel like, to your point, those are the biggest bang for the buck activities. Now that all my things are in healthy range, I see the biggest results from that. So I love to give that advice to women. I’d love to talk more about what you call the forgotten thyroid hormone as well, and how to optimize this, because I think you explained this so beautifully.

Amie: Yes. So the forgotten thyroid hormone is T2. So when I was talking earlier about your thyroid producing thyroid hormones, we always talk about T3 and T4, because those are measurable. That’s what we see on the labs. That’s what your doctor is going to measure. And that’s what we can replace pharmaceutically. We can replace T4 We can replace T3 in medication.

T2 is the forgotten thyroid hormone because there is not an assay, there’s not a test for it unless we’re looking at studies that have been done. And there’s not a drug, there’s not a pharmaceutical for it. It is in supplemental form. So, of course, it doesn’t get as much love and attention as something that’s in a pharmaceutical form. Right. But when you look at the studies of T2, which is the long name for it, is 3,5-Diiodo-L-Thyronine. When you look at the studies on it, they are phenomenal. So I’ve been using this in supplemental form for about 15 years with myself and with my patients, seeing tremendous results. But it was always in kind of like a bro formula, like it was your bodybuilder supplement name. And it was really hard to tell 40 year old mom to go to this mean, angry site and buy this mean, angry name supplement. Right? She’d be like, what am I doing exactly here?

So I’ve been using it, though I would tell my clients, Trust me, try it. It’s going to work. And I saw tremendous results. And then diving into the research on it. There are amazing trials, even human trials, that show as much of as a 4% loss in body fat percentage in 28 days just by implementing and using T2. And that’s huge. When we’re talking percent, we’re not talking four pounds. We are talking 4% body fat loss. What it’s doing is it’s actually acting at the mitochondrial level. So it’s not acting on your thyroid gland itself, where T3 and T4 medication are kind of acting on the thyroid gland. And it does produce a negative feedback loop where the thyroid gland, when you’re taking thyroid hormone replacement, which you might need to do, it’s going to shut down the thyroid gland’s own production of T4 and T3. So, hey, listen, if your thyroid gland wasn’t producing enough anyway, so be it.

But one of the beauties of T2 is that anyone can take it who wants to improve their basal metabolic rate and improve their energy, because that’s what it does. Anyone can take it. And it’s not going to negatively shut down your own thyroid. It’s working at the mitochondria level, like I said, it’s increasing ATP production. So that’s going to produce more really nice, steady state energy through the day. And it’s also increasing your basal metabolic rate. So this is the amount of fat that you are burning at rest, literally just sitting here at rest, doing nothing. It increases your BMR and it does this in two different ways. It acts at the cell level, but it also acts on brown adipose tissue.

So we know that when we you probably have heard this in the biohacking world, all your listeners and you’ve probably talked about it doing cold plunges, why in the heck would we want to get into an ice bath, right? It’s to activate brown adipose tissue. So you actually are turning the white fat, the bad fat that makes us squishy and clogs our organs and it’s not good for us, creates type two diabetes and all kinds of health problems. We’re turning the white fat into brown fat. When we’re activating brown fat, which is actually a fat that you want on your body, you become more metabolically active, your metabolism increases, you reduce insulin resistance, you balance out that insulin and you reduce insulin resistance. You become more insulin sensitive. And that has a host of beneficial health effects in and of itself when we activate the fat. So that’s just kind of T2 in a nutshell, it has many other factors. It reduces lipids, it brings cholesterol into just this perfect form. It balances out cortisol. So it has so many different effects on the body, we’re not giving it enough attention.

And what I have seen now, bringing it to my own supplement line and thyroid fixxr, now, I have seen the feedback from the general public beyond my patients and they are reporting back just tremendous effects of body fat loss. Being able women will be like, I actually cleaned my house and went to the store and went to work today and I didn’t need a nap. It’s like, this is a win. This is fantastic. So we’re getting tremendous feedback from it as well, but the studies are there to support it.

Katie: Yeah, I remember the days of feeling the thyroid symptoms and that is a huge win to have the energy to do extra stuff. And I think that’s a great benchmark to pay attention to.

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And I love that you talk about this because you’re right, it’s not often included in the mainstream message at all. And I feel like often the things that work for bodybuilders ironically are often sometimes helpful. Like in that case because they’re trying to decrease their not just weight but body fat. And so anytime we can find something that for women actually help support that process, it seems really exciting.

Amie: Yeah. There’s one other spin off since you said that Katie. So bodybuilders are the OGs of biohacking. Like you got to give them credit. They were trying peptides long before we knew about peptides. Right. So I heard this coach that coaches the professional bodybuilders, the pros, and he even said, he said, let’s face it, in the world of bodybuilding some bodybuilders will abuse T3 medication. They’ll take the thyroid hormone T3 in order to lose weight for competition. And he said, I don’t let my competitors take T3, I use T2. Because T3 will burn both body fat and skeletal muscle and it will shut down their own thyroid production. So that after the show they come off of everything that they’ve been doing and here comes the weight and now they’re hypothyroid. They basically created a hypothyroid state for themselves.

He said, I use T2 because it only has an affinity for burning body fat. It does not burn muscle. In fact some studies actually show that it activates muscle. So they’re calling it like exercise in a bottle. I tend to be careful with that because I don’t want anybody just sitting on the couch and not lifting. Block that out. But he said, yes, it only has an affinity for body fat, not muscle and it won’t shut down their own thyroid function. And here’s me listening to this guy clapping. I’m like yay. That’s it! Because it’s nice to hear from somebody like that that is just straight up like, hey listen, bodybuilders abuse T3 flat-out and T2 is the next big thing for getting ready for a show too, because you’re going to burn fat and you’re not going to lose muscle.

Katie: That is fascinating. I did not know that. I want to circle back also to the topic of progesterone because you mentioned that this can be a big one for women in various hormone phases of life. And I’m curious what your approach is to addressing if there is low progesterone going on, what is the best way to get it back in a healthy range? How do you approach that?

Amie: Yeah, progesterone, let’s just use the real, right? We can use cream, we can use compounded, we can use oral, always the bioidentical, always bioidentical and we can do different doses. So you might have a younger woman with heavy periods or missing periods and you’re looking for Picose and maybe she doesn’t quite fit that insulin resistance high androgen component. But oh look, here’s the tanked out. Progesterone. Okay, let’s use like 50 milligrams of cream or let’s use 50 milligrams of oral and just cycle that 14 days on, 14 off in her cycle. As we start to get a little bit older and we’re starting to hit later years, even like late thirty’s, forty’s, late forty’s. That’s when sleep starts to decline and anxiety starts to come in. I always say the classic low progesterone scenario is poor sleep and someone close to you, be it a family member or friend, goes, what is wrong with you? Why are you being so bitchy? And that is low progesterone. And it’s not you, it’s low progesterone. So that’s when yeah, let’s try an oral.

Because oral bioidentical oral is actually converted in the liver to allopregnanolone and that has a very calming effect on the brain. So that’s the form that usually gives most women a little bit better sleep and a little bit better, we’ll say, anxiety, agitation, control. Although some women don’t do well on the oral. I always like to start with the oral, see how people tolerate it, unless it’s a younger person. But then we’ll go with the cream if we can’t. We can do a Dutch test to see how you actually methylate and process your hormones. Sometimes that will tell us like, you really have to do cream in this instance. But I would say the majority of women do really well with the oral and they get that extra sleep benefit that they might not feel with the cream.

Katie: Good to know. And I know, like we’ve talked about thyroid being the master gland and sort of affecting everything. This is a very multifaceted approach. What are some of the other whether it be supplemental, lifestyle, dietary factors that you approach with your patients on this that can be sort of universally helpful.

Amie: Absolutely. So insulin is another big one. We have to check for insulin resistance. I see insulin resistance in maybe 95% of my patient population with hypothyroidism or Hashimoto’s because again, that thyroid gland being the master starts to dysregulate your blood sugar. You end up getting more elevated insulin levels even when you’re eating right. I’ve had people say, Listen, I’m eating low carb, I’m eating carnivore, and they’re still insulin resistant because the thyroid is off. So we optimize the thyroid, but we also look at and address insulin. Maybe we’re using something like Berberine. Maybe we are changing them over to a lower carb diet than what they’re on already. But you have to address insulin because it’s very inflammatory and insulin is one of the hormones that will increase reverse-T3. Remember the bouncer at the club? We don’t want reverse elevated. We want to keep reverse down so your T3 can get to your cells. So we want to keep insulin in check.

Another big factor is Ferritin. So whether or not you’re anemic, but specifically your iron stores, which is your ferritin marker, those we actually want between 80 and 100. Now, again, normal lab value range, huge. Are you going to be told that you’re normal if you come in with a ferritin of 30? Yeah. But you’re not going to feel great because the symptoms of low ferritin mimic low thyroid. You can gain weight, you’re going to be tired, your hair is going to fall out. So we have to get that ferritin level to an optimal range as well. Again, so everything is working in conjunction. Everything is working just like a symphony.

So we’re not just doing one thing here and hoping it sticks when all of these other issues are floating around out here, because that’s where you see the person or you hear the person say, I’m just not getting better. Yeah, because you’re addressing one thing or the practitioner you’re working with is addressing one single thing, and they’re missing all of these other factors that play a role. Magnesium is huge. Magnesium is so important for so many different factors in your body, from your heart beating to your sleep, muscle contraction, T4 to T3 conversion. That’s another big player. Iodine, I am a fan of. I love Dr. David Brownstein’s work. I think he’s gone deep into the world of iodine and it benefits everything from hair growth to weight loss, fibrocystic, breast endometriosis, and of course, lowering reverse-T3 and improving thyroid function and improving that T4 to T3 conversion. So those would probably be my top factors outside of thyroid and the sex hormones. Then we have to kind of go down the path of those micronutrients diet, insulin, all those other factors that can come into play.

Katie: Yeah. What about lifestyle factors? Like, for instance, light exposure and sleep? It seems like those can at least be made worse or better in a lot of cases if there are thyroid issues going on and at least anecdotally with me, I noticed getting the right amount of sunlight at the right times of day made a drastic difference in my sleep, which also seemed to be very thyroid supportive.

Amie: Definitely. And I’m glad you brought that up, Katie, because it’s one of those things that sometimes we do overlook because it’s so simple, and especially in our world, it’s like, well, yeah, of course sleep is important, right. But educating the community, educating our clients, patients, audience is vital. And I will often circle back to the basics, to my patients, and to remind my audience, let’s not forget about the basics, too. Let’s not get into a situation where you’re like, well, I need more thyroid hormone because I’m really tired during the day and I must need an increase in my testosterone, I must need more supplements. And it’s like, are you sleeping? Because if you’re not, well, no, I’m going to bed at like eleven because the kids are stressing me out. I have to work and I’m doing this project and sometimes it’s the basics. Right.

So just what you said light exposure at the right time. Get up, walk out and look at the sun. Stand in your bare feet, in your grass if you can, for a bonus if it’s not minus ten degrees out, but look at the sun. That simple, simple act can improve your sleep later in the day and it’s hard for people to grasp that. Like what is looking at the sun at 07:00 a.m. Going to do for my sleep at 10:00 p.m.? It will. It helps reset your circadian rhythm and your best times of sleep, your restorative times. And I know Katie said this on the podcast, but I’m going to repeat it. 10:00 p.m. to 02:00 a.m.. Don’t be going to bed at eleven and twelve and making excuses because you’re losing out on that restorative sleep and your body needs healing. If you are listening to this podcast and resonating with anything that we’re saying, your body needs healing, even if you don’t know what that is yet.

Maybe you don’t know you have a thyroid problem, maybe you have no idea where your hormones are, but you are feeling off. Sleep is the number one thing that you can do for your body to rest and repair, and it’s also going to have an impact on your adrenal gland. So that’s another factor that I forgot to mention earlier. Adrenals are vitally important for thyroid function and we see a lot of, even if you don’t want to use the term adrenal fatigue. We see a lot of dysregulation of the thyroid of T4 to T3 conversion. We see increased reverse T3 when Cortisol is off again. All the adrenal supplements in the world are not going to override a bad night’s sleep. So let’s get back to the basics sometimes.

Katie: Yeah, I think that’s such helpful perspective, and I know it can be, especially for people who are very interested in the health and wellness world. It can be exciting to research the latest biohacks or supplements or all these things, and they can be very helpful. But over and over I’m reminded the longer I’m in this world of just go back to the basics first, because all of those other things you’re going to bolt on are going to be so much more effective. So before you’re buying the expensive red lights, get sunlight. Before you’re buying the expensive biohacking devices, get sleep. Before you’re like buying super expensive supplements and trying to dial everything in, just make sure you’re eating nourishing foods as a baseline and then build from there. But you’re right. I think often the human tendency is to overlook things that are simple, when often over time, it’s the consistent simple that can have the biggest impact if we actually make it a habit.

Amie: Yes, exactly.

Katie: Awesome. Well, and I know we’ve covered a lot of ground. Are there any other specific recommendations you would make to a person who is resonating with some of these things we’ve talked about and suspects something is going on or is where I was twelve years ago and knows something is wrong, but is having trouble getting answers when it comes to testing or their holistic approach of starting to try to resolve those issues.

Amie: Yeah, no matter where you are in your journey. The biggest thing that I could tell anyone listening who resonates with this is let’s start with testing. First of all, let’s start with testing and let’s really make sure because you can tell a lot from your testing and you can tell a lot from listening to your body. Your body will tell you. And just like you mentioned earlier, Katie, those signs and symptoms are gifts because they are signs that your body is literally gifting you to say this is something that you might want to look into, this is something that you can catch. Now if you pay attention that won’t cascade down a deep dark hole, you can catch it right now.

So listen to your body, be in tune with your body, don’t ignore it, don’t ignore the gifts it’s giving you and let’s get some testing. And then from there, then you can figure out who to work with, especially if you do see something going on. Or like you said, Katie, if you’re getting told that you’re normal and every time you leave that doctor’s office, you’re like really normal. Oh yeah, I don’t feel normal. I don’t feel good at all because I was misdiagnosed six times. So medical gaslighting is real. Don’t let it get in your head and think that you’re crazy. You just keep searching. And it might really take working with a specialist who knows what they’re doing in this area of thyroid and hormones to get down and dirty with your numbers and your symptoms and really guide you to the right treatment path to fix you. But start with the testing. Start with listening to your body.

Katie: Yeah, so important. And I probably sound like a broken record, but I say this every chance I get on this podcast, which is at the end of the day, we are each our own primary health care provider and the responsibility for our health lies with us. And it’s really helpful and necessary at times to have a practitioner who is a great partner in that. But at the end of the day, if your partner is not showing or your practitioner is not showing up as a partner, find someone who will and realize that you still have the responsibility for your daily decisions that are going to make the long term impact on your health. And just find a good practitioner who is your partner in that. It sounds like you are one of those rare Gem practitioner partners who really helps people unravel it and get to the root for themselves. So I’m very grateful for the work that you do.

A few questions I love to ask toward the end of interviews, the first being if there is a book or number of books that have profoundly impacted you as a person and if so, what they are and why.

Amie: Sure. So actually having absolutely nothing to do with a thyroid whatsoever, my favorite book, and has been for years since I read it, biggest impact on my life is Driven by Dr. Douglas Brackmann. And for all of you crazy, driven type A individuals, this book is a game changer because it lets you understand who you are in the world. Because oftentimes as entrepreneurs, as driven as just us Type A crazy people, we tend to think that we’re really abnormal because we’ll get the comments, why do you work so much? Why this, why that? Why aren’t you just retiring and laying on a beach somewhere? I’m like because I would lose my mind. This book really lets you see who you are as a driven individual and it lets you better understand the people in your life or maybe in your team that aren’t. But you also see how vital they are in your world and in the world to make it all go around. So that book would be my top, actually.

Katie: I love it. I will put a link to that in the show notes as well. Any other parting advice for the listeners today that could be related to thyroid health or entirely unrelated life advice?

Amie: Kind of going back to what we just talked about, I like to expand on the nuanced part of thyroid. So one of the things I see quite often, both in my Facebook group from my patients themselves, is that they have gone to just the world of functional medicine, right? So we have conventional medicine and that’s where you may or may not get diagnosed. You might get gasoline, you might get told that you’re normal. Okay? And you keep hearing about this biohacking as functional, integrative, alternative kind of space. Well, in that space, not everybody’s a thyroid expert. They might be a gut expert, they might be a lyme expert, they might be an Epstein-Barr virus expert. Interview them just like you would interview your doctor, just like you would interview a new employee, because you want to make sure that they are just as good of a fit for you as you are for them.

So interview them to make sure that they do all of the testing. What do they use to treat the thyroid or hormones? Are they able to prescribe thyroid or hormones if you require it? So really look for people that are nuanced in this area because you could spend tens of thousands of dollars and I’ve seen it and I’ve heard it on people, just because they have that functional or integrative label and they don’t know thyroid and hormones, it’s a very nuanced art. It really is.

Katie: Well, and on that note, I will of course have links to all of your work in the show notes so people can find that at wellnessmama.fm. But where can people find and keep learning from you online?

Amie: Yeah, absolutely. So we have The Thyroid Fixrr podcast, which Katie is a guest on as well, and that’s on all podcast platforms. And then, of course, social media at Instagram @dramiehornaman. I do have a Facebook group, it’s a public Facebook group that you are welcome to join. So in there, you can actually post your labs and you can ask questions. And I will be in there personally jumping in and giving you feedback so that maybe once you get those labs, you can say, hey, these are my symptoms. Does it look like a problem here? And you will receive my advice, but a ton of just love and support from the community that’s in there. We have almost 6000 women in there right now, 6000 people. So men are welcome too, but it’s called girlfrix for thyroid and that’s on Facebook too. So all social platforms, but definitely the website. dramiehornaman.com, the podcast and the Girl, fix your thyroid Facebook group.

Katie: Awesome. And like I said, those links will all be in the show notes. If you guys are listening on the go, that’s all at wellnessmama.fm, along with notes I’ve been taking throughout this episode. Dr. Amy, thank you so much. I feel like thyroid is such an important topic for women and you have such great expertise in this. I’ve learned a lot in this episode. I’m very grateful for your time. So thank you for being here.

Amie: Thank you. It’s my pleasure.

Katie: And thanks, as always to all of you for listening and sharing your most valuable resources, your time, your energy and your attention with us today. We’re both so grateful that you did and I hope that you will join me again on the next episode of The Wellness Mama Podcast.

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.