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Patients asking questions around weight loss, stubborn weight loss, inflammation, why they
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feel like they've tried everything and they can't get the weight to go down.
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And the thyroid can often be the missed piece of that puzzle.
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But if your t three is low or reverse t three is high, your body is literally fighting
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against fat loss.
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Welcome to Health Decode, your number one source for real health information with your
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host, doctor Alessi and Matt Tack.
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Welcome back to another episode of Health Decoded.
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I am your host, doctor Alessi.
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And today's episode is going to be focused around what we are calling the hidden thyroid
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weight connection.
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Now, is a topic that I really have been looking forward to digging into for a while, and
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something that's been a little bit more prevalent as of late.
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Patients ask asking questions around weight loss, stubborn weight loss, inflammation, why
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they feel like they've tried everything and they can't get the weight to go down.
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And the thyroid can often be the missed piece of that puzzle.
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And so we're going to take this into a four segment part episode that way you know what to
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expect.
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Segment one is we're going to talk about why the thyroid controls your metabolism, what the
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thyroid is, how it works.
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Segment two, we're going to get into what are some symptoms or red flags of thyroid and
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weight dysfunction.
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Then we're going to talk about how we test the thyroid in functional medicine, not just with
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basic testing, but comprehensive labs.
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And then we're going to pull it all together and talk about how do we fix the thyroid and
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weight connection in functional medicine.
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And so, thank you for joining me today.
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If you've been listening to the show for a while, you know that we're just here to decode
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the myths around health, provide value to our listeners and help educate and impact those to
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go spread the word to others.
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So if you've enjoyed the show, please share, please follow so you can stay informed and then
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share this with someone that you know could benefit from the information.
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So let's at least let's get started here.
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Okay?
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So if you're not familiar with what it is, your thyroid is a small butterfly shaped gland that
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sits right in the front of your neck.
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And it's small, but it's the master regulator of your metabolism.
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And in functional medicine, we call it the thermostat.
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It basically controls how your body burns calories, how much energy you're gonna produce,
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how warm or cold you might feel and even how sharp your brain is.
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It even controls the rhythm at which your heart beats.
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And so every single cell in your body has thyroid hormone receptors.
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And so when the thyroid is off, a lot of things downstream can be affected.
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And so the way the thyroid works, right?
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And we've touched on this briefly in past episodes, particularly in like the gut and
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hormone episodes, but your thyroid does not work in isolation.
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It's part of what we call an axis, particularly the HPT axis, which is your hypothalamus, your
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pituitary gland and your thyroid gland.
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And there's basically a chain in which they talk to each other.
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And so the way it works, your brain's pituitary gland, which is inside your skull, sends
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signals, which is thyroid stimulating hormone.
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It sends that signal like a boss giving instructions to the thyroid.
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What happens then is your thyroid is going to produce T4, which is the inactive storage form
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of thyroid hormone.
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Then, T3, which is the active form, the body needs to convert to that, correct, right?
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So the one that actually enters the cells and tells them to crank up metabolism is your T3.
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This is your, the fat burning hormone, right?
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Now, reverse T3, think of this as the emergency break.
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So, if your body is stressed, inflamed, or you have a lot of toxicity, it can convert T4 into
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reverse T3 to try to slow things down.
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So, your body's trying to always maintain a level of balance.
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Now, most T3 is actually made outside the thyroid in your gut and your liver.
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And so, when people have poor digestion, when they have things like SIBO, leaky gut, inflamed
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gut, toxic overload, This can actually go back upstream that axis and affect the thyroid and
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cause dysfunction.
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And so, you know, when the thyroid slows down even a little bit, weight loss actually becomes
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kind of like that uphill battle.
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You could be eating clean, exercising, doing all the right things.
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But if your T three is low or reverse T three is high, your body is literally fighting
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against fat loss.
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We always talk about how our approach to fat loss in functional medicine is very much
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focused on becoming healthy first.
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Your body is not going to prioritize losing fat or burning fat when there's inflammation and
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there's dysfunction.
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It's going to prioritize the fires first.
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And so, there was a study in the Journal of Clinical Endocrinology and Metabolism 2019 that
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said even subtle thyroid dysfunction, which is high to normal TSH or low T3 is linked with
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higher body fat and metabolic slowdown.
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There's also another study out of Lancet in 2020 that said individuals with TSH in the
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normal but upper range had significantly higher rates of insulin resistance and weight gain
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compared to those in the lower to normal range.
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Now, the reason that's important is because standard conventional medicine is going to read
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a lab within reference range as normal, tell you you're fine, go about your day.
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They wait until something goes dramatically wrong for them to take action.
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In functional medicine, we narrow the reference range to be optimal, not just normal.
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And so, a lot of you know, conventional docs, they're only testing the TSH.
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They're looking for TSH and maybe T3 or T4.
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They're not checking reverse T3.
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They're not checking the antibodies that could be causing the thyroid to be, you know, your
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body to be attacking its own thyroid tissue.
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And so, that's where we must take a deeper look.
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And so, I want to use an example what we call like a patient case example.
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And I'm not going to use any names but basically had a patient, she was 38 years old.
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She was working out often honestly like five, six days a week, maybe more than she needed to
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be.
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And she was eating what we would consider a clean diet, but she was very exhausted,
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fatigued.
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She had things like thinning hair and she couldn't lose weight no matter what she was
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trying.
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And so, all these signs, obviously, first thing I was thinking was hormones, thyroid, let's
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investigate.
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She had gone to her family doctor who told her her labs were fine.
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She brought the labs to me.
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All they had run was which was at like a 3.9 which they you know, still considered normal
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but is on the higher range.
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And then we ran a full panel and we saw that T3 was low, reverse T3 was high and she had
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antibodies for what we would call Hashimoto's which is an autoimmune thyroid disease.
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And so once we address this, we did some more testing and we actually addressed her gut.
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And we found leaky gut syndrome.
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And so, when the gut is inflamed and damaged, it can cause what's called leaky gut or
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basically intestinal permeability.
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The gut is starting to break down.
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And so, we had to not just go straight for the thyroid because you know, standard medicine is
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going to put medication in you on to focus on the thyroid.
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We had to go to the gut first, right?
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What was the root cause?
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So we worked on balancing the gut, fixing the gut issue, then supporting the thyroid on the
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back end.
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The symptoms went away, obviously that was actually the first thing that happened.
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But then upon retesting, we found that the panel got better and the TSH was back down at
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normal range, optimal range I would say.
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And the antibodies weren't gone but they were starting to go down as well.
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And so then now for her, was just a matter of supporting that and maintaining that lifestyle
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that we had incorporated.
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So, that's just an example of what can happen, right?
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And why functional medicine takes a deeper look and why we focus on things like that.
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Now, let's get into the next piece here where we can talk about like what symptoms or red
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flags you can expect or should be looking for with thyroid weight dysfunction, we call it.
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And so, some of the common hypothyroid symptoms, hypo meaning slow or low thyroid, are
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things like weight gain, especially like stubborn belly fat, even when you're eating
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clean and working out.
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Cold intolerance, if you're always needing a sweater when other people are comfortable.
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Chronic fatigue, you wake up tired even with enough sleep.
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You're fatigued throughout the day and you just can't catch up on sleep.
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Brain fog, very common is to have like that slow thinking, poor memory, difficulty
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concentrating, poor recovery from exercise, thinning hair, dry skin and brittle nails,
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right?
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Basically like collagen kind of symptoms.
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Constipation and bloating.
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So definitely gut issues are very common with a low thyroid.
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And then in females, irregular or heavy menstrual cycles more than normal or off of the
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actual standard cycle.
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And now the opposite of that is what we call hyperthyroid.
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Hyper meaning fast or elevated, right?
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So on the flip side, it's kind of the opposite of all those symptoms, right?
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Unexplained weight loss despite eating enough.
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Anxiety, nervousness, people getting like palpitations, that jittery feeling.
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Insomnia, right?
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Maybe feeling wired at night, unable to sleep, sweating excessively, heat intolerance, and
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then frequent bowel movements or diarrhea.
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These are again, very much the opposite of the hypothyroid.
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So, there's two different ranges here.
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And now, let's dig into kind of what you could experience with what we call like the hidden
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culprit, which is Hashimoto's.
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And I've shared my story many times on here, but this was what I was dealing with.
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I had a hidden Hashimoto's even with normal thyroid, right?
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And so I was, my body was attacking its own thyroid tissue.
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Was just a matter of time that I possibly would go low thyroid, but I was able to get ahead of
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it.
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And so Hashimoto's actually accounts for ninety percent of hypothyroid cases.
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But it doesn't show up overnight.
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It takes time for this to build with very vague or even like subtle symptoms that people won't
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notice.
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And it can swing between the hyper and the hypothyroid.
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People can feel wired for bits of time and then exhausted for bits of time.
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And they're just very much fluctuating on this spectrum.
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And by the time it gets diagnosed, honestly, usually much of the thyroid tissue has already
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been damaged.
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And so, in a journal of autoimmunity reviews 2019, autoimmune thyroid disease often precedes
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diagnosis by years with nonspecific symptoms like fatigue, mood swings, weight fluctuation
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dismissed as stress, aging or just you're being a mom, right?
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We hear that all the time.
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Oh, you have kids.
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This is just normal to be feel like this.
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And so, the subclinical hypothyroidism is often linked to increased abdominal fat and insulin
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resistance even before full blown disease developed.
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So, these are just things to be aware of, right?
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We always say symptoms are not normal.
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Symptoms are your check engine light.
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Everybody has a car, right?
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We drive our car, check engine light comes on, you need to figure out why it's going on.
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That's what your symptoms, your pains, these dysfunctions are.
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And so, now that we know what the thyroid is, why it matters when it comes to metabolism and
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weight, we know kind of what to look for, what red flags.
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Let's talk about how we test this to make sure we're in the right playing field.
00:11:39
But first, let's take a quick word from one of our sponsors.
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He ate clean.
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But beneath the surface, even unknown to him, his body was breaking down until one day he
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crashed.
00:12:04
Full blown fatigue, burnout, he couldn't even think or make it through the day without a nap.
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After finally turning to functional medicine blood work and discovering he had an autoimmune
00:12:16
thyroid condition caused by leaky gut, he was able to take action and restore his health.
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00:13:09
Alright.
00:13:10
Welcome back.
00:13:11
Now, let's talk testing because this is where most people are curious, most people want to
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take action, and where most people get completely missed or dismissed by their
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conventional doc.
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And so, the reality is that most conventional doctors, as I said before, I'm gonna beat this
00:13:26
dead horse, they only test TSH and maybe T4.
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That's like checking the gas gauge in your car without ever looking under the hood, right?
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It gives you a sliver of the picture, but it leaves patients walking away with a you're
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fine, things are normal diagnosis when they clearly don't feel fine.
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So, our full thyroid testing approach looks like this.
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At Alessi Functional Health, we're going to dig deeper.
00:13:50
So, a true thyroid assessment includes TSH, free T4, which is the storage hormone, free T3,
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which is the active hormone, reverse T3, which is the basically the metabolic brake pedal.
00:14:04
We're going to check thyroid antibodies, TPO and TG to screen for Hashimoto's or
00:14:09
autoimmunity.
00:14:10
And we're going to check total T3 or T3 uptake, which is a deeper look at how your body is
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transporting those hormones.
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And so, that's not enough still.
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For functional medicine, we want to test further.
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We want to look into the gut because the gut is often associated with these dysfunctions
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upstream.
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And so we can do gut testing.
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We have a really awesome test called the deep gut scan.
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It's going to test for zonulin, calprotectin, stool panel that's going to basically look into
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the system, the ecosystem of the gut.
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Is the bacteria within balance?
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Is their leaky gut syndrome?
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Is there IBD or IBS?
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We also want to test for micronutrients.
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So looking at things like selenium and zinc because these are very important for building
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the thyroid.
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These are basically the raw materials your thyroid needs to function.
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We also test the adrenals with a salivary test because stress and thyroid are basically two
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sides of the same coin.
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And as always, we like to test for toxins.
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Testing for heavy metals, BPAs, pesticides, mold can basically tell us if there's any kind
00:15:14
of like endocrine disruption being had from these types of toxins.
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And so, you know, some of the red flags that we catch that others could miss, Things like a
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normal TSH that's at the higher range, but then free T3 is at the bottom, but it was never
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tested, right?
00:15:32
Or prime example, young mom with low ferritin positive antibodies, but she was dismissed as
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postpartum fatigue because they didn't look deep enough into the testing.
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And so she had the symptoms, but there was not enough testing done to create a diagnosis,
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which you know, would be early Hashimoto's in this situation.
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And so there's a cool study out of Frontiers in Endocrinology 2021 that confirmed that thyroid
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antibody positivity can precede clinical hypothyroidism by five to ten years.
00:16:06
So oftentimes people have the thyroid antibodies building, but the actual thyroid
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hormones are not being affected yet.
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And so without full testing, these patients are told they're fine while under the surface, the
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immune system is actually silently attacking their thyroid.
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Again, this is my story.
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And so, you know, if you're only testing the TSH, you're practicing 1980s medicine.
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That's what I'd say.
00:16:30
Because functional medicine in the age that we live in, we have the ability to test all the
00:16:35
things that matter.
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We have the ability to be proactive and preventative, and not just waiting for things
00:16:41
to fall apart.
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And so, you know, speaking of that, let's talk about how we can now transition from taking the
00:16:49
data from testing and actually fix the problem, right?
00:16:52
Not just cover it up, not just manage symptoms, but fix the actual dysfunction.
00:16:57
And so, this is where things get exciting.
00:16:59
This is usually where people are like, Oh, I want to hear this part, right?
00:17:01
I want to know what to do.
00:17:02
And so there's an appropriate way to do it.
00:17:04
And so, you don't just slap a medication on it, call it a day because then you aren't really
00:17:10
creating any conditions for the thyroid to actually recover, you're just covering it up.
00:17:14
And so, functional medicine is root cause.
00:17:18
When we say that it means we're getting to the root of the problem, right?
00:17:21
And so, oftentimes inflammation is not even the root.
00:17:25
It's something causing the inflammation that then is causing the dysfunction.
00:17:28
And so, have to really dig deep with our questioning, with our testing, and then come up
00:17:32
with solutions.
00:17:34
And so step one is always, always, always remove the triggers.
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Like what foods could be triggering the dysfunction in the gut or in the thyroid?
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Is it gluten, dairy, processed sugars that are leading to inflammation?
00:17:45
So gluten in particular is a known trigger for autoimmune disease.
00:17:51
Environmental plastics, things like BPAs, pesticides, heavy metals, endocrine disruptors
00:17:56
that block thyroid hormone conversion.
00:17:59
And so there was a study actually, Environmental Health Perspectives 2016 found
00:18:04
that BPA exposure was significantly associated with altered thyroid hormone levels in women.
00:18:11
And so, here's a practical tip.
00:18:13
We're always fans of that, right?
00:18:15
Is swap your plastic water bottles for stainless steel or even glass.
00:18:20
And then going organic when it comes to the foods that are on that dirty dozen list that we
00:18:24
talked about.
00:18:25
These can make a big impact of not continuing to put the things in the body that are causing
00:18:31
the issue, right?
00:18:32
Step two, heal the gut, right?
00:18:34
So step one was remove the triggers.
00:18:37
Step two is going to be heal the gut.
00:18:39
If 70 to 80% of your immune system is in your gut, then that's right where autoimmunity
00:18:43
starts.
00:18:44
And so, we use specific tools, specific tests.
00:18:47
We actually have a protocol that's six months to take you from you could be completely
00:18:52
wrecked to all the way completely healed.
00:18:55
Your gut is functioning perfect and normal And then obviously from there, we target the actual
00:19:01
things like the thyroid that need attention.
00:19:03
And so, then from there, step three, right?
00:19:07
What I just spoke to is support nutrition, right?
00:19:09
And so, we use specific nutrients for thyroid things like selenium, which reduces antibodies,
00:19:15
helps convert the T4 to T3.
00:19:17
Iodine, you know, obviously within a specific amount, we don't want to do too much.
00:19:23
Zinc and B12 are very important because these are critical coenzymes for hormone production
00:19:30
and energy.
00:19:31
And then vitamin D is responsible for immune regulation and metabolism as well.
00:19:37
And then step four, balance the hormones and the stress.
00:19:40
And so we can use certain things like adaptogens, but also prioritizing lifestyle,
00:19:44
sleep, exercise, movement, all these things are lifestyle medicine practices to help to avoid
00:19:52
flare ups.
00:19:54
And then step five is using advanced tools, right?
00:19:58
We can dig in and get deep with things like peptide therapy.
00:20:02
Peptides like thymosin alpha-one or BPC-one 157 can actually modulate immunity and repair
00:20:08
tissue.
00:20:08
We can work on benefiting the mitochondria supporting the mitochondria and then targeted
00:20:13
nutraceuticals.
00:20:15
We also have access to really cool things called bio regulators.
00:20:18
I do a course of bio regulators maybe once a quarter or every other you know, every four to
00:20:23
five months to give my body the raw building blocks it needs to build back up tissue.
00:20:29
And so in particular to the thi the thymoline one.
00:20:32
And so, you know, sometimes medication is necessary.
00:20:36
I always like to say we're not like anti medicine, we're just pro doing something that
00:20:42
makes sense.
00:20:43
And so, sometimes medication is necessary, you need to take a course of it, but it's not going
00:20:48
to be the fix.
00:20:49
And so, can use it for a bit to get you back maybe stable, but getting to the root cause is
00:20:54
always going to be the long term plan because that's where we'll actually correct the
00:20:58
problem.
00:20:59
And so one last, little quote here, the American Journal of Lifestyle Medicine 2021
00:21:05
concluded, and this is huge, that lifestyle and dietary interventions remain the foundation of
00:21:11
thyroid health, even in autoimmune thyroiditis.
00:21:14
Basically translate that you can't out medicate lifestyle.
00:21:18
Take all the medicine you want.
00:21:19
If you don't change your lifestyle, if you don't change your habits, nothing's going to go
00:21:23
away.
00:21:24
You're going to be stuck in this cycle.
00:21:25
And so really final takeaway, thyroid dysfunction isn't a weight loss death sentence.
00:21:31
But if you don't fix the thyroid, no diet or workout plan is going to get you there.
00:21:36
And so you need to start from the root, right?
00:21:38
Is it the gut?
00:21:39
Is it the thyroid?
00:21:40
Is it the hormones?
00:21:41
Find out where the problem is, correct that, and then your body will want to prioritize
00:21:46
losing weight.
00:21:47
And so this is why in our total care program, we don't just take a glance, we map out
00:21:52
everything.
00:21:52
We're going to guide you along the entire process.
00:21:55
And so, if you would like to learn more about how we help diagnose, reverse and heal thyroid
00:22:00
dysfunction and weight loss through our functional medicine programs, go to
00:22:05
alessifunctionalhealth.com, Schedule a consultation with me or one of my other
00:22:09
providers and let's create a personalized plan for you.
00:22:13
Listeners of the podcast, you're always going to get exclusive discounts and price reductions
00:22:18
on all of our protocols, lab testing and follow ups and stuff like that.
00:22:22
So be sure to mention where you heard about us.
00:22:25
As always, I do ask you if you found value in this episode, please like, subscribe to the
00:22:30
show and then share this with someone who needs to hear it.
00:22:33
That's how we grow the message and that's how we change more lives, the impact piece.
00:22:37
Also, you want to get in touch with us or be featured on an episode, share your story, email
00:22:42
us your questions at askalessiefxhealth dot com.
00:22:46
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I'm Doctor.
00:22:59
Alessi, and I'll see you on the next one.
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