The Thyroid Fix You Probably Never Heard Of - With Dr. Amie Hornaman

So if your thyroid isn't working, there's nothing that is working. There's nothing that you can do. This is what I see. They're doing the most perfect diet, the perfect exercise regimen. They're doing all the supplementation, they're doing peptides, they're doing all the things, and they're not seeing the results. They'll say, listen, the scale is not moving down, and in fact it's moving up. And that is the thyroid's control over your metabolism.

In this episode of the Boundless Life Podcast, I'm doing a throwback to a conversation that I had with Dr. Amie Horneman. I'm re-airing this because Amie is one of the world's leading voices in thyroid health, and this is still probably one of the most comprehensive conversations that I've had on the subject. She got misdiagnosed 6 times before anyone figured out what was wrong with her, and that's what sent her down this thyroid road. And she really has an approach that is anything but So, if you've been told that your thyroid labs are normal and you're still feeling terrible, this one's definitely for you. Usual note, neither of us is giving medical advice. This is for informational purposes only. So, proceed at your own risk or benefit. The shownotes are at BenGreenfieldLife.com/ThyroidHealth. I'm always curious when I talk to people who are big experts in a particular field, especially for you, Being a doctor, how'd you actually get into specializing in the thyroid? And also related to that, since your approach seems so much different than the standard Synthroid prescription doctor approach, where'd you kind of veer away from, I don't know, standard sane medical advice into all this woo-woo stuff?

Into all the thyroid stuff. Well, I'm like most of us in this space. It was a pain-to-purpose journey. So, like you, years ago, years ago, I competed in fitness and figure competitions. I did fitness modeling. So, I mean, you've talked about this on the podcast before. It was the chicken, fish, asparagus, gym twice a day regimen. I mean, you're killing yourself.

That's right, BRICKN, chicken and brown rice. Yeah.

So good. Memories, such great memories. So, I was doing all the things. I had done multiple shows before. I had done multiple preps for photo shoots before, so I knew what to do with my body. I knew what worked, what didn't work. This one show was a big one and your listeners that compete will know it's the NPC Pittsburgh. So, I was getting ready for a pretty big show at the time and checking in with my coach, doing the weigh-ins, all of that. And, I'm getting on the scale week after week and the scale's going up. And, we know biologically that doesn't make sense whether you believe in calories in, calories out or not.

Yeah.

Does not make sense with what I was putting into my body, what I was expending. No, unacceptable. So, I kept going to my coach. We kept talking. He was trying to troubleshoot. Every week I get on the scale, 10 pounds, 15 pounds, eventually 25 pounds heavier. Now, I'm frustrated.

Geez.

Right? Yeah.

And, by the way, you were in full-on competition phase eating, like you said, the chicken and rice and cutting calories and I would imagine exercising pretty heavily and you were up 15+ pounds. Yeah, yeah.

I stopped weighing after it hit 25+ pounds because I was just depressed. I mean, I fell into a true depression, despair. And, I mean, you always think people at the gym are judging, oh, she's not doing it right, she's eating too much, look at her, she's just gaining weight. Here's a fitness model not looking so good. So, I did what we all do, I went to my doctor. And, at the time, I wasn't into functional medicine at all, I just went to regular conventional allopathic sick medicine trusting that they would have an answer because I knew my body was rebelling against me. So, I figured, well, if I go with all my symptoms, they're going to test something, they're going to tell me what's wrong, I'm going to get an answer on a pill. So, I do that and I'm told, you're normal, everything is fine, eat less and exercise more. I was like, right, that is even possible with the regimen that I'm on. So, doctor number 2.

Yeah.

I don't stop. I don't accept that. I move on. Doctor number 2, doctor number 3. Now, we're 4, 5, 6, all of them telling me that I'm normal. And, I know Just like I'll tell your audience, you know when your body is off. You absolutely know when your body is rebelling against you and there's something wrong. So, I kept plugging away, I kept going. And, they all told me it's all in my head, eat less, exercise more, your BMI is fine. Meanwhile, I'm bringing in what I'm eating, I'm bringing in my exercise regimen saying this doesn't make sense. No one would give me an answer.

Yeah.

Finally, doctor number 7 says, oh, you have a thyroid problem. You have a goiter on your thyroid. You have Hashimoto's. We're going to do an ultrasound and confirm it, but here's a pill. So, I left her office pumped. I'm like—

Wait, wait. Could I ask you something?

Yeah.

What's a goiter?

Oh, it's a little growth on your thyroid. So, your thyroid's a butterfly-shaped gland in your neck. So, she did touch my neck and she actually said swallow. This is the first doctor to actually do Yeah. The touch test of my thyroid. And, she ran a couple other blood labs and said that she wanted to get an ultrasound. So, she felt some growths on my thyroid gland. So, she knew that something wasn't right. And, whatever number she looked at on paper, she called me hypothyroid, which I was totally okay with because I had a name for it finally and I had a pill.

Yeah. Right?

So, I thought this is going to be it. I'm going to finally lose this weight. I'm going to feel better, all the things. I gave it 5 months, nothing happened, absolutely nothing. Not 1 pound lost. I didn't feel better. I was still gaining.

And, what was the pill that she gave you?

Synthroid T4. T4 Levo, Synthroid T4.

And, Synthroid, it's just T4. Which means that there's, I believe, 4 different thyroid hormones and the Synthroid replaces one of them.

Right. And, we'll get into this. We'll get down and dirty with the thyroid hormones. Just for right now, T4 is inactive. So, that's the thing to remember is that T4 is totally inactive. It is standard of care though. That is what you learn in med school. You learn to test one test for the thyroid, And, if it is above the standard lab value range, which we know is taken from sick people, if it's above that standard lab value range, then you're given a pill and that pill is T4. Now, I mean, we could go down rabbit holes and say the makers of Synthroid sponsor med schools and give funding and all of that, but that is the standard of care.

That's what's taught. No, no. Don't do that. I don't want to lose my pharmaceutical company sponsorship of this podcast episode.

Right.

Don't go down that rabbit hole, but let's keep going.

Right. So, I was given T4 and I start Googling on my big Gateway computer back in the day, what about these thyroid hormones? I'm on T4, it's not working. So, I start to see this thing about other thyroid hormones that are really, really important. And, I went back to my doctor and I'm like, hey, maybe this regimen, this protocol that you have me on, I know it's not working. Maybe it's not the best for me. How about we try something else? She goes, I don't do that. I go, well, I'm going to find somebody who does. And, that's what led me into functional medicine where a functional medicine practitioner literally saved my life, did all of the tests, changed the thyroid hormone therapy that I was on, implemented a supplement regimen that actually would work for me and work for my body and work for the numbers that he was seeing.

Yeah.

And, he became my mentor and that's what totally changed my career. And, I just thought, well, wait a minute, here I am 20-something and I'm dealing with this in a pretty large city. I was in Pittsburgh, Pennsylvania, pretty large city, huge medical system, and I'm getting the shaft. So, how many other people are getting the same shaft all across the United States, let alone the world? So, that's what landed me here. And, I specialize in thyroid and hormones. And, here I am helping people.

So, what kind of doctor are you exactly?

I'm a doctor of clinical nutrition and a functional medicine practitioner.

Okay, okay, got it. And, you took a deep dive and studied all this thyroid stuff. Who is this mentor, by the way? I wonder if I know him, the thyroid guy.

His name is Dr. Len Brandtsewitz. He's in his 70s now. He practiced in Pittsburgh, PA. He had his own radio show. Yeah, I don't know if he's practicing anymore, but—

Yeah, yeah. I don't think I know of him. But, back to the thyroid, when you were gaining that weight, because I am super curious about this, is it water weight or do you know when people start to see this increase in the metabolism? And, just so you know, the reason I'm asking this is I'm doing some math in my head about the whole calories in, calories out equation. And, And, I'm just curious if the added weight is kind of cortisol-related water retention and bloating, if it's an actual formation of new fat in response to a drop in metabolic rate, or did you ever think about that or dig into it?

Formation of new fat based on the decrease in metabolism because your thyroid's the master. I mean, that is the start of all metabolic processes including fat burning. So, if your thyroid isn't working, there's nothing that is working. There's nothing that you can do. And, this is what I see with the people that I work with. They're doing the most perfect diet, the perfect exercise regimen. They're doing all the supplementation. They're doing peptides. They're doing all the things and they're not seeing the results. They'll say, listen, the scale is not moving down and in fact, it's moving up. And, that is the thyroid's control over your metabolism.

Okay, got it. I got a lot of questions for you about the thyroid now. So, you said earlier that the doctors run this kind of test for the thyroid and they test for certain things. Is that test inadequate?

No, no. So, you go to your doc, you say, listen, I want to get my thyroid tested. If you don't specify the test that you want, you're going to get TSH, thyroid-stimulating hormone. And, that's a pituitary hormone, it's not a thyroid hormone. And, it's an okay test, but again, in functional medicine, we have optimal lab values. Standard conventional medicine has their standard lab value range that we said earlier is taken from a group of sick people. Functional medicine takes people like you, takes the fit, the healthy, and we say, where are they at? And, that's that really narrow optimal range that we want you to fall into. So, with TSH, even just that marker alone, In functional medicine, we want that below a 2. Standard medicine won't call you hypo until you're above a 4.5 now. So, it's an okay test. If it's screaming at us, if someone comes in and it's like, wow, your TSH is a 5, yeah, there's a problem, but there are so many other tests that we have to test.

Okay. So, you got TSH. And first of all, the reference range for that you're saying should be closer to 2 than 4+. So, if you're looking over your lab values and I don't know, you got an InsideTracker or WellnessFX or your doctor scores or whatever, you might have to look a little bit more closely if that flags as A-okay because that might actually not be a proper reference range for what you would consider to be true thyroid health.

Right, exactly.

Okay. What else do you test?

Okay. So then, we go down the line, we go free T3. That is the active thyroid hormone. So, I mentioned I was given T4.

Yeah.

That's inactive. We will test the free T4 for sure. We'll do a total and a free T4. And, that gives us a little bit of information, but where I really like to focus, what I want to see is the total and the free T3 because that's your active thyroid hormone. And, the free form of it tells me how much of that active thyroid hormone is in your body ready to be taken up by the cells. So, if we look at a cell, the receptor site on that cell is for T3. There's no receptor site on your cell for T4. There is for T3. So, I want to see how much free active thyroid hormone is in your body. Then, I want to look at reverse T3. So, reverse T3 is your anti-thyroid hormone. The analogy that I love to use is a bouncer at a club. That bouncer is just standing outside your cell door, Yeah. Arms crossed looking at T3 being like, you're not getting in. You're not getting in today. So, if there's too much reverse T3 in the body, it's going to block T3's action at the cell level. Where we see elevated reverse T3 is in clinical settings like the ICU, the ER. When you're injured, when you're in a trauma state, that reverse will go up and it's a survival mechanism. I mean, it's beautifully built into our bodies. But we don't want it elevated when you're walking around trying to live life. You're not in a hospital bed. We don't want you to have elevated reverse T3. So, this also tells me how well you're converting your inactive thyroid hormone T4 over into the active thyroid hormone T3. Beyond that, we test for the Hashimoto antibodies. So, that's TPO and TGA, thyroperoxidase, thyroglobulin. That tells me if you have hypothyroidism that is an autoimmune form where your body's attacking your thyroid gland.

Okay, got it. Would that only be for Hashimoto's that someone would have these elevated thyroid antibodies?

Yeah, those are just Hashimoto antibodies. I mean, we could run an ANA screen. That's kind of a general autoimmune marker, but the TPO and TGA are just for those autoantibodies attacking the thyroid gland.

Okay. So, you got this one subset of people who's maybe not eating enough calories or not eating enough carbohydrates and exercising too much and you're getting a downregulation of thyroid that you could test. But then, are you saying there's another population of people who have an immune condition in which their thyroid is under attack?

Oh, yeah. So, 95% of all hypothyroidism is actually Hashimoto's. So, we have that Yeah. Small percent of the people just like you said, Ben, that they're over-exercising, they're over-dieting, or maybe they did chemo, radiation, they're taking a drug that is downregulating their thyroid function. But, 95% of hypo, low and slow thyroid patients fall into the Hashimoto category. Now, it could be that the diet and exercise overdoing it actually flipped that autoimmune switch to the on position too. So, The over-exercising, over-dieting, low calorie definitely will have an effect on the thyroid directly, but it's also a stressor on the body that can flip on the Hashimoto switch.

Oh, this sounds a little bit like something like leaky gut syndrome or a food allergy where a stressful incident in life or something that triggers almost a cell danger response syndrome causes someone to all of a sudden have an autoimmune reaction to certain foods. Or a permeable gut membrane that they never had to deal with otherwise in life and there's a life incident that flips that switch that maybe they weren't born with but that is now activated from a stressful scenario.

Yeah, exactly. It's that whole 3-legged stool analogy for all autoimmune conditions where definitely having a leaky gut, that's going to set you up for that autoimmune switch to turn on. And then, here comes that stressful event.

Okay, got you. And obviously, this kind of leads to the question, this is probably a rabbit hole a little bit, is what do you do if you find out the values are off? And, it sounds like there might be 2 different approaches depending on which thyroid dysregulation that you're looking at. Yeah?

There is. I mean, here's the thing. Even if you have Hashimoto's, how are we going to treat you differently? Okay, we're probably going to use something like low-dose naltrexone, black cumin seed oil, Yeah. We're going to mandate that you go gluten-free because gluten is a molecular mimicker to the thyroid, so that can induce an autoimmune attack. But, I'm still going to treat those low thyroid hormones. It's not like, oh, you have Hashimoto's, so you're going to get T4 monotherapy while everybody else gets T4 and T3. I'm still going to look at those lab values that we just talked about and I want to get those in an optimal range and I want to get you in an optimal range Ultimately, eradicating your symptoms. So treatment might vary slightly, but at the the end of the day, we want you optimized.

Okay, got it. So so let's go back to the optimized piece. Assuming that Synthroid, as you've just explained, is not necessarily the answer because it's inactive T four. What would you actually do to restore thyroid function?

So let's look at those labs, right? So let's say you're coming in with a free T three. That is suboptimal. I won't even say low because it's not necessarily going to be flagged low on that standard lab value range, but maybe it's low according to my functional standards. Then, we have to look at the fact that here's a stat for you. Only 2% of hypothyroid patients do well on T4 monotherapy. 98% do well on T4 and T3 Or T3 alone. So, right there, we have to change the treatment. If someone is on T4 only, it's not going to work. It's not going to work. We have to add in some T3. So, let's add in some T3. We can use natural desiccated thyroid like Armour or NP. I have no problem with the synthetics. I have no problem if someone's on Synthroid and they're doing well and their reverse T3 is okay, it's optimal. I know they're converting their thyroid hormone.

Yeah.

But, the T3 is low. Okay. Well, let's add in some liothyronine. Let's add in some Cytomel. Let's add in that T3 to get a better balance, skip the middleman, give you some of that active thyroid hormone that your body needs and that your cells require. And now, all of a sudden, you're feeling better. Now, if there's a reverse T3 issue where the person is having issues converting, then we might lower the T4 and add in the T3. Maybe we do T3 only. I'm T3 only. I don't convert. I never tested my genetics to see if I have a D101 or D102 SNP, but I don't convert. You give me T4, I get worse. So, I'm T3 only. Some of my patients are. It's all about that personalization aspect and finding the right combo that's going to work for that individual.

What about T1 and T2? Why are we just talking about 3 and 4?

Oh, I love the other thyroid hormones. Love it. So, Yeah. T1 and T2, very important. T1 is inactive. We can kind of set that aside, put it in the same category as T4. But, T2, oh, this baby. I've been studying T2 now for 15 years. And, I joke, Ben, that bodybuilders were really kind of the OGs of biohacking because, I mean, you know when you were doing it, we tried everything on ourselves. I mean, you try everything on yourself now, but we tried everything on ourselves long before it came into Mainstream, right? So, 15-20 years ago, and T2 has been studied for 30 years, but about 15-20 years ago, I started looking into it because as you know, many people, many bodybuilders, competitors, people looking to lose body fat will use T3 in order to lose body fat whether they have a thyroid problem or not. And, the problem that I saw when I was competing were especially among the ladies, a lot of these girls were using it to burn body fat, get show ready, and then they came out the other side and would put on 30, 40 pounds a couple weeks after the show. And now, they have a thyroid problem because they shut down their own thyroid production. They basically created that negative feedback loop. Now, they're hypothyroid.

Sounds similar to a guy who gets on a bunch of testosterone when they're young and inhibits fertility and LH and FSH and has this big uphill battle to climb if they ever stop taking it.

Exactly. I mean, our bodies are smart. It's going to shut it down if we're taking something that we don't need. So, T2, not in medication form, in supplemental form, T2 will decrease body fat. So, it'll actually increase your basal metabolic rate. It will stimulate brown adipose tissue. And, I can go into the studies on this, Yeah. But, in a nutshell, it protects your muscle. So, where T3 will come in, cause a thyroid problem, burn fat and muscle. So now, you get to the show, now you look flat on the stage because you wasted your muscle. You come out the other side, you're going to gain 40 pounds and have a thyroid problem. T2 will only burn body fat. It will protect muscle and it will not downregulate your own thyroid. So, back in the day, Yeah. The trainers to the pros were using T2. And, I actually saw one interview where he's like, yeah, I don't let my women competitors use T3 at all. I give them T2 because we can get it in supplemental form. We don't have to buy it on the black market. We don't have to get a doctor to prescribe it. And, oh, hey, it's only going to burn body fat. It's not going to shut down their thyroid production afterwards. So, it's actually— I mean, T2 is amazing. The technical term is 3,5-diiodo-L-thyronine. And it is in supplemental form. It is not in medication form, although we do see it in natural desiccated thyroid products medication, the Armour, the NP, because it is naturally produced by your thyroid gland. It's one of the four thyroid hormones, although it's in it's in a teeny tiny amount in the NDT medication, whereas what we use for the studies is higher.

Yeah, so so T two you call three five diodo L. Yes. Okay. So, if I have a supplement and you're saying this could be an over-the-counter supplement and I want to, I don't know, enhance brown adipose tissue activation from cold or I want to lose fat but not lose muscle, I could literally take this as a supplement without having to get a prescription from a doctor?

Yes, absolutely. Yeah. That's what I put in one of my formulas, Thyroid Fixxr, because I've been using it for 15 years. I started using it when I was competing. I started using it with my patients. And anecdotally, I was just seeing these amazing results, amazing fat-burning results with no effect on their thyroid lab values. So, yeah, that's the beauty of it. I mean, until the FDA clamps down on us and figures out, hey, this is really good, let's put it in a pill, it is available in supplemental form.

You made this— is that this black bottle, Thyroid Fixxr? That is.

Yep, that's what's in Thyroid Fixxr.

I did not put 2 and 2 together. Okay. Because 4 bottles of that showed up at my house 2 months ago. And, I read the label. I wasn't quite sure about the 3,5-diiodo-L-thyronine. Now, it makes sense if that's the T2. But, I took a bottle to Italy and we went to Italy. And, since Italy, I've been telling everybody, well, we're riding all over the Hill Country like madmen on bicycles. I was eating cake for breakfast and gelato for lunch and pasta for dinner and came back and I'd lost 7 pounds. But now, I'm wondering how much that stuff came into play because I was popping 3 capsules of that every morning.

Yeah, yeah. No, it'll help.

What's the downside? I mean, in terms of T2, are you going to see any type of negative feedback loop or hormonal downregulation?

I have combed through all the studies, the rodent studies, the human studies. I have combed through them.

Yeah.

And, I cannot find a negative. There was one study that showed there's a potential downregulation of TSH, meaning your TSH might go low, in which case, okay, if it goes super low, your doctor's going to say, oh my gosh, you're hyperthyroid. But, that was just one single study done in rodents. All the other studies show no thyromimetic effects. So, no effect on the thyroid gland itself, Because this thyroid hormone T2 works at the mitochondrial level. It doesn't work stimulating the thyroid to pump out more thyroid hormone, it's actually working at the mitochondrial level.

I wanted to get your thoughts on this whole ketosis low-carb thing and whether you think there's anything there as far as lack of carbohydrates suppressing thyroid.

So, the studies show that it's only in long-term low-carbohydrate consumption. So, I mean, a lot of my patients, end up being insulin-resistant because of the thyroid problem. So, thyroid master gland controlling sex hormones, controlling all the hormones in our body including insulin. So, we see this glucose dysregulation, insulin resistance in the majority of thyroid patients. Now, what do they do? All of them go on a low-carb diet because we see that they're insulin-resistant. Maybe they'll throw in some berberine. But, if they are low, low, low carb like under 20 or 30 grams of carbohydrates day after day, month after month, year after Yeah. Then, we will see a little bit of a downregulation in free T3 production, in the T3 production of the thyroid gland. But, it's not significant enough for me to say, oh, that low-carbohydrate diet being in ketosis is bad for you because there's so many other positives. Whether you're doing carnivore, which, okay, it has upsides and downsides, but a lot of people will do carnivore just to reduce that inflammation. And, that has a fantastic effect on Hashimoto antibodies. And, the reduction of those. So, if it's working for you, if the low-carb diet, if carnivore, if being in ketosis is working and you feel better and your brain's alive and you're keeping a stable weight, then who cares if your free T3 drops a little bit? I mean, you can always come out of ketosis once a week or once every 2 weeks.

Yeah.

And, that's enough to just kick that back up again.

Okay. This idea of long-term carbohydrate deprivation, deleteriously affecting thyroid kind of makes me think about something else I wanted to ask you that you see bandied about a lot in the, particularly the nutrition sector, and it is that you should do refeeds. And I've even seen a number thrown out there as 4 weeks, like don't go any longer than 4 weeks without some kind of like a refeed weekend or a binge Saturday or, you know, a big cheat day or whatever. Because if you do that every 4 weeks, you push the reboost button on your thyroid. I've seen other people say as often as every 1 week. But, is there any science behind or anything that you know about this idea of calorie cycling and having basically refeeds on particular days of the week to keep the thyroid elevated if you're otherwise restricting calories on other days?

Yeah. I mean, I haven't seen any hardcore evidence or studies on it, but what I normally tell my patients And, this will happen naturally because you're just living a normal life, right? Once a week, once every 2 weeks, go ahead and enjoy. Now, I'm not talking about a cheat day where you go all out and it's like, okay, let's do the pizza, beer, and brownie diet, but just bringing your carbohydrates up. Eat sweet potatoes, have that fruit that you've been craving, have some dark chocolate, bring your carbohydrates up to 100, 150 but with good quality carbohydrates. And then, that's enough to bring you kind of out of that ketosis. Now, obviously, if you're metabolically efficient, you're going to snap right back into ketosis then the next day or 2, but it's enough to bring you up out and that's all your thyroid needs. So, whether it's maybe it's once a week based on your lifestyle, based on your social schedule, and plan it out that way so you can live a life.

Yeah. There's half the people I think who hear that and are going to put an extra cup of blueberries in their smoothie. And then, the other half of people just heard you say have donuts every Saturday.

Yeah.

So, it's going to widely vary. So, with the thyroid, you talked about T2, talked about Synthroid and some of these other natural options like, say, Armour. But, what about these folks who are just using desiccated thyroid glandula? You talked about the carnivore diet, right? A lot of those people maybe because the Liver King guy, Bryan Johnson, had an ancestral supplements company and would sell these thyroid capsules. I know there's a lot of other companies. I think Heart& Soil does one. I know there's a few others out there, but it's basically just claims to be T1, T2, T3, and T4 because it's just the ground-up thyroid gland of an animal. Do you think that's beneficial at all?

So, this is a story going back about 15, 20 years, maybe 20 years ago. There was another company that had it out. And, I swore one day because I would use this with my patients and I would see lab values change and I would see improvements happen. And, I said, one day somebody's going to figure out that there's T3 and T4 in here and take away the glandulars. And, they still haven't yet. But yes, I mean, so glandulars are supposed to. And, if you look on Ancestral, if you look on those companies' websites, It will say, oh, there's no active thyroid hormone in these glandulars. But, just like you said, Ben, they're drying the thyroid gland out of a cow. So, is there a little guy picking out the T3 and the T4 and the T2? No. I mean, those thyroid hormones are going to be dried in that thyroid gland. So, yes, I do think that they are beneficial. There's a caveat though if you are not a converter. So, going back to what we talked about before about that T4 to T3 conversion.

Oh, yeah.

If you're not a converter, those glandulars are 80% T4, 20% T3, just like Armour Thyroid, just like NP Thyroid. They are 80% T4. So, if someone's a non-converter and they take a glandular, they could actually get worse.

Yeah, I see where you're going. You can see an elevation of reverse T3. So, your bouncer in front of the cells would actually go up.

Yep.

Okay, cool. That's good to know. So, you'd actually have to do a little bit of Pre-testing or look at that genetic SNP that you talked about before you determine if that approach might work for you. What about coming— I know that's not really a whole foods approach, although some would argue it is, but another thing that comes up a lot is the recommendation for using these seasonings that are ground-up sea vegetables like kelp and dulse and kombu or nori, eating a diet that's rich in sea vegetables and including a lot of these components in your diet. What do you think about that approach for things like iodine and selenium, for example?

Right. So, that's the iodine selenium piece. So, here's my take. And, as you know, in this space that we're in, you could find 50% of the people saying Hashimoto hypothyroid patients shouldn't do iodine and 50% will say that they should. I'm in the camp that iodine is good because if you really look at it, every cell in the body needs iodine. Just like every cell needs thyroid hormone, every cell in the body needs iodine.

Yeah.

And, when you look at the studies on iodine, iodine will reduce reverse T3, it will help with T4 to T3 conversion, it helps your hair grow, it helps with fibrocystic breast disease, it's used for your immune system support. So, why not take iodine? We don't have to take it in excess, we don't have to take abnormal amounts that's going to cause a thyroid storm, but we can take enough for support and for conversion help. So, I'm a fan of using straight-up iodine just because some of the Like you said, the sea kelp and the the salts. I mean, you're not really getting number one. You're probably not getting the amount of iodine that you need, and you might even overdo it if you're taking an iodine supplement and you're doing all the sea vegetables. And I mean, listen, I love me some good sushi, but I'm not going to use that as my sole source of iodine. I'm going to take a really high quality iodine supplement. And then for the selenium, I see too many. Oh my gosh! These thyroid patients, they will go on every blog. every forum and they see selenium and then they start popping 200 mgs of selenium a day. Now, their selenium goes up. Now, the reverse T3 goes up. So, I tell people, my God, just eat a Brazil nut or 2 per day to get your selenium. It's cheap and you're not going to overdose on it.

Yeah. Fun fact, keep the Brazil nuts in the freezer. Those things tend to get notoriously moldy. They don't have a good shelf life. So, I actually have Brazil nuts and I keep them in the freezer and I pop a couple Every now and again for primarily the selenium that you talked about. But, I also interviewed a friend of mine, Dr. Leland Stillman. He said the same thing about iodine that you are really championed the idea that it actually is a helpful supplement for a lot of people. He uses it with a lot of his patients. He was taking— I don't want to get this wrong. I'm going to say what I think he said on the podcast, but I'll link to it in the shownotes. We may have to go back and check, but I think he said he was around somewhere in the range of 50 to 70 micrograms a day.

Yeah.

As a little experiment that he was doing and feeling fantastic. And, since talking to him and looking at a few of the options for iodine out there, I actually started a couple of times a week to take 150 micrograms of iodine, the Life Extension Formula. And, what's interesting is that I fly a lot. And, if you look at all these things like bentonite clay and magnesium and chlorella that are all talked about as a way to Uh, to, to combat the effects of radiation, X-ray radiation, solar radiation, even the type of radiation you might get from a dye injected during, say, like a CT angiography, which I recently got, that iodine is the only supplement that actually has scientific data behind it for helping to combat the effects of radiation exposure. So there's kind of a bonus to having it around. You know, if you're going to go on a long-haul flight or go get a heart scan or something like that, It appears that iodine is good for that too.

Oh, yeah. I squirt it up my nose when I'm on a plane. I keep it in a little spray bottle and dilute it with saline water and put it up my nose because it's so good for the immune system. And then, for the thyroid gland, iodine will bind to the halides that are toxic to the thyroid gland. So, it's going to bind to chlorine and bromine and fluoride and all those fluoride treatments that we got as kids. I mean, it's going to bind to that in your body and help your your body detoxify from those halides, it's only going to help support your entire body detoxification processes and support your thyroid gland too, actually protect the thyroid from all those toxins that like to attack it.

Yeah. So, all you have your kids in swim or you're a master swimmer in the chlorinated pool all day, make sure you have some sushi or some sea vegetables, use some iodine. I wish I'd known about that when I was doing a lot of triathlon because I was in chlorine almost every day. And, that's it. Notorious halide that affects the thyroid.

Yeah.

So, something to think about there. And then, the other thing that I'm seeing a lot more of, Amy, is this idea of peptides. There's the research out of Russia. Dr. Khavitsyn has done a lot of that research on longevity and decreased all-cause risk of mortality and improved organ function with these very small peptide bioregulators, which TL;DR, you consume certain bioregulators and they go to support that specific gland that they're named after. And, there's one I think is called— I'm going to butcher the name. I think it's called thymosin or something like that, but you take it and apparently it helps to support the thyroid as a peptide. And, a lot of people are swearing by peptide bioregulators and/or peptides for thyroid support. What do you think about peptides?

Okay. So, let's do bioregulators first. Yes, I interviewed Phil Mickens on my podcast too. Fascinating, fascinating. Okay. Yeah. And, what's crazy about it is it will work whether you're hyper or hypo. I mean, it's amazing these bioregulators coming. Now, you have to have a thyroid gland. So, if you have a thyroidectomy or you had your thyroid radioactive iodine, not going to work. You have to have a thyroid gland for the bioregulators to work on it, but it's almost like an adaptogen but so much better. It will literally balance out the thyroid. So, if you're making too much thyroid hormone and you're hyper, it's going to calm that down. If you're making too little, it's going to help your thyroid gland kind of amp up and produce more, kick out more thyroid hormone. So, that's the bioregulator. But peptides, that's where we can get into thymosin alpha. So, we know that that's immune-regulating. That's going to help people with Hashimoto's because we see with Hashimoto's, like we said, it's your body attacking your thyroid gland, your little Yeah. Your little soldiers in there think your thyroid gland's a bad guy and they're going out and they're beating it up and they're attacking it until your thyroid gland becomes this weird-looking small tiny little gland that can't produce T4 and T3 anymore. So, when we support the immune system, use thymosin alpha, then we see almost a downregulation of those autoantibodies. They start to calm down. The soldiers stay in their barracks.

Yeah.

So, peptide-wise, I love thymosin alpha. I love MOTS-c because we see, like I said earlier, a lot of insulin resistance with hypothyroidism and Hashimoto's. So, MOTS-c is really good. And then, just the growth hormone ones, CJC-1295, ipamorelin. So many of my patients have the hair loss and they will literally say, I feel like I've aged 10 years in 1 year.

Yeah.

So, we bring on the growth hormone peptides and now they're seeing this more luxurious hair growth and they're seeing improvements in their dry skin from their thyroid condition. And, I mean, it's not the miracle fat loss drug. We know, and you've talked about this before on your podcast, these growth hormone peptides, they act slow. This is a marathon, not a sprint, right?

Yeah.

So, you're not going to see, oh my God, I dropped 10 pounds in a month from using CJC. No. But, over the long haul when you're doing all the things, that's just going to stack on top of your regimen and help with all of the symptoms that you're seeing.

I just wanted to ask you while I have you on the show, I know we don't have a terribly long amount of time left together, but it's testosterone, particularly for women. Because I understand, I think I saw an article on your website where you talked about this. And, I'm curious, what's your take on that? Because I'm hearing a lot of talk about sexual function and orgasm quality and things like this for women who use a topical testosterone or a hormone replacement with testosterone. What's your take on that?

This is my second passion next to thyroid is testosterone and the importance of for men and women. So, I mean, really, we're hearing it more and more from men these days, TRT, all of that. I mean, it's talked about more mainstream, but I think women get left behind in this testosterone talk because when we talk about women's hormones, we think estrogen, we don't think testosterone. But, testosterone is the most abundant hormone in a woman's body. Now, you guys have more of it, but it is our most abundant hormone. And, I call it the get-shit-done hormone. It gives us motivation, it gives us drive, it gives us strength, it helps with body fat, it helps with libido.

Yeah.

It helps with hair growth. I mean, it helps with so many things that if you don't have enough of it, you're not going to want to do anything. I mean, you're not going to want to have sex, yeah, but you're also not going to want to go to the gym, you're not going to want to work, you're not going to want to think, you're not going to want to do. So, testosterone for women is vital. Now, here's the problem. Again, going back to conventional medicine and those standard lab value ranges, a woman will get cut off in that standard lab value range Most of them end at 48 total. So, I'm looking at the total testosterone right now. It'll go 2 to 48. So, if a woman comes in with a test level of 50, which in my mind is the bottom number for optimal, I like my ladies at 50 or above for testosterone, total testosterone. So, a woman comes in with a 50, she's getting flagged high. Her doctor's telling her, oh, you have too much testosterone. You must have Yeah. PCOS or you have an androgen problem. Meanwhile, she's just hitting the bottom of the barrel of optimal. I really think that, I mean, men, you guys get told you're normal too if your testosterone is 400. And, we know that that's horrible. But ladies, I love, I mean, when you get that testosterone number up and you give a woman who is low in T, you give her testosterone replacement therapy whether it's a cream, I will use injectable with my ladies too, troches, however you want to do it. The only thing I stay away from are the pellets because that's where I see female levels go to dude levels and that's where you'll get the women saying, I lost all my hair. It's like, yeah, well, you converted the DHT because your test was a 900. So, that's not a good idea.

I was going to say, I assume that you're looking at lab values because I would imagine if you're just looking at total T, You could put a woman on testosterone, see something like over-aromatization. I don't know if excess estrogen could lead to a risk of breast cancer or something like that, or you might see that it's not bioavailable because sex hormone-binding globulin is too high because they're under a lot of stress. I would imagine similar to a man, you can't just take testosterone as a woman and assume you're just good to go, right?

Right, yeah. No, it's all about the dose, the administration, how she pushes to the 5-alpha reductase pathway. So, how she's going to aromatize her testosterone into DHT.

Yeah.

We look at that. And, I mean, we can tweak it, we can personalize it, we can really make it fit her. So, if we're using something like a cream, I'll go 10 to 20 mgs per day because there's always a crapshoot with the cream with absorption and utilization. With an injectable, I mean, we can do something as simple as 10 milligrams a week or 10 every 2 weeks. And, that's enough to just bring— I mean, it just lights a woman up. And here's the thing with the thyroid too, tying it back, low levels of testosterone. And this is one reason why women get hit with Hashimoto's more than men because again, you guys have more testosterone for protection. Testosterone protects against autoimmune. So, women get hit with Hashimoto's more often because we have lower levels of testosterone in general. And then, you have the group of women that just have low T, period. And, when you give that testosterone, male or female, you actually protect against autoimmune. So, you can lower the Hashimoto antibodies by bringing those testosterone levels up to optimal.

Wow, interesting. Yeah, I thought about recommending testosterone to my wife, but I thought, yeah, we should just test blood first just in case. Her levels came back at 68, so I told her she's good to go. It's probably because she's just outside all day in the sunshine pushing around wheelbarrows and Bringing alfalfa out to the goats and just kind of living a primal lifestyle out there. And, I think she's okay on testosterone. But yeah, I think a lot of women don't know about this. And so, that's really helpful to hear the reference ranges and your approach on that. We're out of time, but man, I mean, your website is a deep dive into a lot more. You get into peptides for women and other lab tests for other hormones and constipation, what to do if you're losing your hair, and a lot of really, really helpful advice. I'm going to link to your website in the show notes and to everything else that you do and then to some other podcasts that I mentioned like the one with Phil Micans, the one with Leland Stillman, et cetera. So, obviously, a lot there. I'll take detailed show notes and get them down there for everybody at BenGreenfieldLife.com/ThyroidFixer. And, correct me if I'm wrong, Amie, but even though you're based out of Pennsylvania and kind of the Northeast area, you would do Consults or teleconsults and things like that with people?

Yep. We can actually— my team, I built a team that we can now prescribe to all 50 states because I do feel that I don't claim to be able to heal everyone's thyroid naturally or with supplements. I mean, just like we talked about, sometimes thyroid hormone replacement or bioidentical hormone replacement with testosterone, sometimes that is required, oftentimes that's required. So, we can prescribe to all 50 states. So, absolutely, I do the one-on-one consults. My team does them. We can prescribe the whole deal for anyone suffering.

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