Still Sick on Thyroid Medication? – The Shocking Truth Doctors Aren’t Explaining with Elle Russ
Elle Russ and McCall McPherson discuss why patients stay sick on thyroid medication despite normal TSH levels. They argue doctors rely on outdated protocols like TSH suppression and levothyroxine alone, and miss autoimmune disease, reverse T3, and dosing issues. Testing full panels and adjusting to combination therapy often resolves lingering symptoms.
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So excited for you all to join this conversation today. It is with Elle Russ, who is a number one bestselling author of The Paleo Thyroid Solution, a groundbreaking book that has transformed thyroid health worldwide and has been translated into multiple languages. She's also the creator of The Ultimate Thyroid Course, the most comprehensive thyroid education program available, empowering people to finally get the answers conventional medicine has missed. Let's dig in. Well, it is rare that I get to kind of talk and nerd out with other people that specialize in thyroid, so I'm So excited. Thank you so much for being here today, Elle. Let's have a nice, good thyroid chat.
Yeah, thanks for having me. This is an important topic. It's, uh, every day someone wakes up with thyroid issues all over the world, so it's— that's not going to stop, so we've got to keep talking about it.
Right. And I know it's like people wake up with thyroid issues, they're on thyroid meds, they still feel horrible, they have all the classic symptoms of a thyroid problem, but they go to their doctor and are just kind of shot down and told, hey, this isn't your thyroid, it's not that, go eat less, exercise more. What do you feel like as someone who's worked with thousands and thousands of people in terms of their thyroid recovery, where do you feel like medicine is going wrong and continuing to go wrong?
Well, you know, they have a lot of false fears based on outdated protocols from like the '70s. So if you're still fearful of something that has been debunked, Right? You're hurting a patient. That happens a lot with a suppressed TSH, which we see a lot. So that's where a lot of doctors keep patients sick, and it's really with outdated protocols. What I talk about in my book with Dr. Gary Forsman is the thing that's really frustrating for doctors like him and other functional medicine practitioners is this is the stuff that they geeked out on in medical school. This is why you went to medical school, 'cause they're like, oh, let's solve this. I wanna get people better. And then somehow after medical school, you open your practice and the curiosity falls apart suddenly.
Yeah.
And you're not willing to listen to patients. And so it's not just where doctors are failing, it's literally where healthcare is failing. If you've got 15 minutes and you're looking for a surgery or prescription, you don't have time to say— perfect example, my fiancé has celiac disease. He doesn't eat gluten. It's one of the easiest autoimmune, you know, disorders if they have. He had a ton of stomach issues, IBS-like symptoms. Vertigo, then a rash showed up. He was going to the doctor. They kept doing all the blood tests, the gut issue, everything. And meanwhile, nothing was happening. And I'm going, hmm, this sounds a lot like, uh, something my friend might have an issue with. I called my friend who has mast cell histamine intolerance.
Okay.
And, uh, we instituted a no histamine diet for literally like immediately, and the vertigo went away within 2 days. The rash went away.
Not weird.
One doctor said, what are you eating? And it could've, it's just, it was the difference between walnuts and bananas and chocolate. And I mean, so simple. Wine versus cider. Nobody asked, what are you eating? So that's a big part of it too. As we know, gluten can affect antibodies in a multitude of autoimmune disorders. And so that's the problem too. It's just healthcare failing people. So I think everyone has to become their own advocate. You've kind of gotta become your own investigator. And it's not fun. I'm sure you might have gone through this yourself. I didn't sign up to be an MD, an amateur MD. I didn't sign up to, you know, I didn't want to do this, but I had no choice because I was left in the dust. Let's see, my thyroid issues started in 2003, 2004, and I live in Los Angeles, and I went through 2 dozen endocrinologists and doctors, specialists. I ran to the doctors on Suzanne Somers' hormone books. I did everything. Went out of pocket and nobody could help me. And so where do you end up there? Now it's better now. It's better now. The information's out there. There's podcasts, there's people learning.
Right.
There's my book, there's your work. There's, people are like, okay, we're catching on. Practitioners are a little bit more open and that's lovely. But if you're a patient, this is what I tell everyone. There's only really 2 reasons you're suffering. You either have an uninformed doctor who is missing one of the key things, either they're not testing, assessing, or treating, or all 3 correctly. Or you don't know enough about this condition to help your practitioner help you. Biggest fail. My life changed when I learned this because I was able to help myself. And the only person that actually helped me get better was me. I dosed myself. I ordered my hormones over the black market on the internet. Don't want anyone to do that, but I had to do what I had to do. And I'd probably be dead by now if I didn't do that. So you have to take your health into your own hands to some degree at a certain point. And it means educating yourself. And I know no one wants to hear that because you're like, really? You got a degree in this. You spent 10 years. You don't know, but you know what? They don't. And you just have to be okay with that and move on.
I totally agree. I mean, I think if I could only tell thyroid people one thing, it would be, look, if a clinician, a doctor, whoever tells you that you're normal and it's not your thyroid, never listen. You know, like you can't just accept that as truth, go on your merry way and live your life. Because if I had done that, I'd probably be on disability by now. Like I just would not be the same person. That I am today. And unfortunately, we can't passively sit back and just give our health, our thyroid, into the hands of someone else and expect that everything's going to be okay. We are not there yet in terms of medicine, our paradigm, our approach, our understanding, um, our training. We're not equipped, you know, and that's the reality. And I'm speaking as a PA, but I've spoken with Over a dozen doctors, including board-certified endocrinologists, and they are not equipped either. And so it takes someone who's gone off on their own and really invested a lot of time, energy, money, capacity into learning this very nuanced art. I think you and I realize how nuanced it is, but—
Yeah.
Medicine as a whole does not. We think it's easy, it's simple. You just increase and decrease doses of levothyroxine-based meds and they're gonna be fine. If they're not fine, it's not their thyroid. It's gotta be something else. Because thyroid symptoms are nonspecific, right? Like it could be anything. But the reality is it's probably your thyroid. It looks like a duck. It walks like a duck. It quacks like a duck. It's probably a duck.
And it's so easy to rule out, and in my opinion, easy to fix, that it's one of the dumbest diseases we have. In my opinion. I really, I do. I think it's one of the dumbest things out there. I'm like, this is one of the easiest things to control, manage, and fix if you do it correctly, whether it's naturally getting rid of it or, you know, someone like me who has to take thyroid hormone replacement. Look, I was left in the dust twice in a decade with 2 serious thyroid problems. The reverse T3 issue was the second one, and then the first one. I had to dose myself both times. I really shouldn't have had to do that, right? Someone— I went to the doctors and I was educated to some degree, and they just were like, we don't want any part of this. So it's really important to learn it yourself enough. And I want to impart this on everyone. I have a philosophy degree, okay? I'm scientifically challenged, okay? I hated biology and math in school. All you need to do is understand this on a deep theoretical level, which is very easy if you've got the right explainer, and then you've got a hold on it. I'll tell you what else I see a lot too. So here's the biggest problem I see with people that are on thyroid hormone replacement, but they're still hypothyroid, because this can happen all of the time, as you know. And so this is what I see. Someone's given thyroid hormone replacement, their doctor's like, you have a thyroid problem. And they're like, oh, what do I do? Well, take this pill. And they take the pill and they might feel a little bit better before than before. But then they're still struggling with one of the many symptoms of hypothyroidism. Let's say, I'm kind of depressed, doc, or, gosh, I still can't lose the weight. And the doctor says something to the effect of, well, that's a symptom that goes in line with hypothyroidism and you have hypothyroidism, therefore no. Because when you fix hypothyroidism, you're eliminating every symptom. There's not lingerers. There's not dingleberry symptoms lying around waiting to be magically cured by a Prozac or whatever. Now, I'm not saying that someone wouldn't have serious depression that would need that. But most of the time you give the person the Prozac, it works for 3 months, and then it won't work 'cause you didn't get to the root of that depression and the T3 receptors in the brain. You didn't get to it. And same with all of the other stuff. So then they're giving you a statin or a blood pressure medication, and it's not that. And so that makes me so sad because there's a person then who thinks inherently these symptoms must continue to exist because I have this stamp of a thing called hypothyroidism. I've had hypothyroidism since like 2003. I've been un-hypothyroid for many, many years. And the reason I'm un-hypothyroid is because I take thyroid hormone replacement that is perfect for me. And so that's really the killer to me is the people that are on thyroid hormone replacement still coming in and then getting a blood pressure pill or a statin or something else because the doctor goes, well, I see this list of symptoms, and they don't understand, no, it's the elimination of the symptoms. Does that make sense? Like, that kills me out there. So that's happening a lot and everyone needs to know that often it's a very simple tweak of your medication. Yeah. Or your thyroid hormone replacement, it's a very simple tweak or an addition or a timing in the dose. And it's a bummer when you get someone that comes to you, I'm sure you've had it too, they've been suffering all these years, going down these rabbit holes, and then it's like, oh, all you need is blink, and it's like a nothing, and their life has changed, and then they're just curled up in a ball, like, how did everybody leave me in the dust? That was me.
Absolutely. I mean, that was me too, and is so, so many of our patients, and I think It's like a messaging issue where people think, well, because I have this, I'm just expected to feel like this forever. And I love that you are clearly trying to say, no, actually you shouldn't feel like this forever. Our whole tagline, like our hashtag at Modern Thyroid Clinic is there's no reason to still have thyroid symptoms.
Like, uh, thank you. I just got goosebumps. Absolutely agree. There is no reason. And here's the thing, and you get it too. Someone comes to you and they're like, I've gone to the Mayo Clinic, the Cleveland Clinic. I've spent 10 years. I'm hopeless. I guess my Nope. And then it turns out it's fixed very quickly and they're like, what? Like I'm working with an 80-year-old right now. Okay. And if I just showed you the labs, you'll see it just like anyone else. You see 'em getting better, you know, as the dose, and you're like, they're like, I feel better. And this has taken literally 3 months.
Right.
She's been suffering for years.
I know.
Reaching, searching. And you're like, oh my God, at least at 80, maybe she's got a good decade or 2 left. I don't know. So it's never too late. So even if you are older or you're, you know, in your 70s, don't drop the ball on it. And I also want to express this to people that are hypothyroid listening to this. And as you know, McCall, like when you're hypothyroid, your brain's not working right.
It's just not. Right.
And I don't know if you had this, but the way I describe it when people go, oh, that's me, is you have such a general malaise, sometimes depression, that you know you need to help yourself, yet somehow you can't. You're like, you can't, you know you need to go, but time's going by. And then you're like, I know I need to go see the doctor. I know I need to, and like time keeps going by. And you're still hypo. The other one that's a crazy maker is— so obviously, if anyone's watching this, I have a huge head of hair, a huge head of curly hair. It's natural. I, you know, I don't have extensions, but it fell out by the handfuls, right, when I was hypothyroid. And so you get a lot of the calls from the people where they're like, great, yeah, I know I'm hypothyroid. How do I prevent my hair from falling out though? And you're like, you fix your thyroid problem. They're like, no, no, I know, but what can I take? Can I do— And the answer is, you can't do anything, it won't work when you're trying to apply modalities for normal bodies onto a broken one, right? Oh, well, I'll detox then. Really? A hypothyroid body, you're gonna detox? How's that gonna work out? Explain it to me. How far did you get? No one succeeds at this, as you know.
Right.
So it's a really weird mind screw because people are like, but I have to work out to get ahead of the weight gain. And you go, right, but working out's gonna actually make you fatter and make the problem worse and hurt your adrenals more. And they're like, I know, but I feel better after I work out. And I ask everyone who's listening, if you're in this, I ask everyone who calls me, I say the same thing. I'm like, all right, great. So when you work out, like 2 hours later, do you feel and like energetic and like tighter? Or are you feeling a little bit fatter around the middle and exhausted?
Exhausted.
And the answer's always the latter. So it's like, right, you just injected some hormones. You just kind of like took a hit of crack to go work out to feel And logically feel like you did this, right? Like, if you're fat, you go work out to burn calories, to lose the weight. And that all makes sense on a body that has a normal metabolism. And so that's why when people are like, I can't lose weight, I can't lose weight. Well, I'll go to keto. And they'll feel good for a few weeks and then they get ultra fat, even fatter, which happened to me way back in the day. It was called Atkins. Mm-hmm. And it's because you're trying to put a high-fat modality on a body that cannot burn fat. And so, It's terribly frustrating, and I'm sure— but I just want to get it out after everyone's had— the symptoms of hypothyroidism go away when you solve the problem, right? You can't solve a symptom of hypothyroidism on its own, if that makes sense, right?
It's so tricky when people are in this construct where, well, my doctor or my clinician isn't helping me. I have to help myself. I'm going to do the work. Meanwhile, they're already exhausted. They can barely wake up and get pants on every day, but They're gonna, you know, change their diet, change their lifestyle. And it's all this resistance, it's all this extra work, it's all this extra tax on their physiology. Whereas if you flip that script a little bit and, hey, you invest the time, energy, money, capacity in finding someone to actually fix your hormones first— like, if we just lay that foundation first—
First.
They all of a sudden have capacity and energy to go work out, and it's healthier. They have the energy to meal prep, to do the basic things that we need to do to be healthy. And that is amplified. You know, all the effects just amplify one another. But if you flip it and you try to do it on your own, it's really difficult. And honestly, like, this especially applies too, I think, for people who are truly, truly hypothyroid and they don't want to take medication. I'm like, look, if you don't take medication, you're going to end up on a diabetes medication. You're going to end up on a cholesterol medication. You're going to end up on all these other meds to solve symptoms that are just being manifested by your thyroid.
Oh, because you don't want to take a medication. So this was my issue and I get this a lot and I'm sure you do. People are like, I don't want to be on a medication. I don't want to, you know, I don't want to be on a med. Well, especially Americans. Like, I get why you'd be scared of meds. You know, you look at all the commercials on TV and you look at the side effects and you're like, geez. But here's the thing. I like to distinguish it. I mean, even though technically thyroid hormone replacement, you have to get a prescription for. I look at it differently than something like the birth control pill, which I have no moral objections to. But when you look at the birth control pill, I look at it like a medication because it manipulates the body into doing something it was never meant to do, and therefore you have a lot laundry list of side effects with that one. And then I look at thyroid hormone replacement or HRT. You know, I'm in menopause right now. It's again, that might be more controversial, but at least with thyroid replacing what your body should be giving to you, and therefore it doesn't come with a laundry list of side effects, and it's not really abused, and. I had someone recently, they were like, well, my doctor told me I should go on Armour, but I looked at the list of side effects and I was like, no way. And I'm like, what did you look at? Like, what did you look at that scared you on there? That would be if someone overdosed on it, right? Or was incorrectly taking it. They are really safe. And the other thing too, obviously, is the pregnancy question. Like, well, what do I do? And it's like, well, if you don't get your thyroid right before pregnancy, you're bound to have a miscarriage or complications. And There's been so many women successfully going through multiple pregnancies on thyroid hormone replacement. So I don't want people to be scared of it because it's a lifesaver, as you would probably say too. It's changed my life. There's no way I would be able to operate. And I don't know how you felt back then, but it's accelerated aging. Like, I look younger now than I did when I was hypothyroid. Like, it's accelerated glycation and then all of the downstream things you mentioned. So you will get type 2, right? And then you're going to be in real trouble. And you're probably going to end up with some gynecological issues along the way as well. And they're going to try to patch that, the uninformed doctors, with, with HRT, and they're going to get that wrong too because they're not going to get to this root, as you know. So I always just say you got to rule it out for everything. For a psychiatric issue, you have to rule it out. Depression, bipolar, any of this stuff, rule out the thyroid. Oh, you need a statin, your cholesterol is terrible. Nope. Right to the thyroid. Oh, your blood pressure. Nope. Right to the thyroid. I mean, and it's not just because we say so or we think it's great. It's because it's the master gland of the body, period. Like, I, you just can't argue with it, right? So it's essential. And I think, and I don't know your age or where you are in the sort of perimenopause, menopause, but it's really important in your 40s. I'm in the rage.
I'm in the rage phase. I'll—
Are you in the rage phase? I'm sorry. Yeah, there's moments of that. It might be an excuse for murder, right? Has it been used? I don't know. But what I always tell people, especially when they're like going into their 40s, I'm like, you better get this thyroid thing fixed up and figured out because What happens is, is a lot of women, including myself in the past, you will have a hormonal imbalance from the thyroid issue, and then they're trying to patch it with the HRT for the female hormones, and it's not that. You got to go to the thyroid first. And also, as you go through perimenopause and menopause, you are going to have a better understanding of everything happening to— with menopause when you're on hypothyroid, on the right meds, or naturally on hypothyroid, whatever it is. And I'm sure you've told your audience this before, because thyroid hormones or the thyroid gland is the precursor. It's like the production regulation of your sex hormones. If you're not padding that up first, you know, I don't know if you've had this before, probably with many women and men, but I had a 25-year-old guy that came to me many years ago and they only tested his TSH. So they ruled out his thyroid, of course. And then they tested his testosterone and it was horribly low. So all they did was give him testosterone. Well, that didn't work. I mean, you know, it may have got the testosterone levels up. He came to me, he had a serious reverse T3 problem. So what we did is we fixed that, got him off the testosterone, fixed the thyroid problem, and his testosterone shot back up to high school levels because he's a 25-year-old and he shouldn't have had the low testosterone. And none of the doctors said, well, what caused it? This happened with me. I was getting my period every 2 weeks at the age of 30. I'm currently 52 years old. So this is when my thyroid problems started. And I was getting my period every couple of weeks and they just kept giving me the birth control pill. Bled through that, another one, bled through that, another one, bled through 4 of them. Meanwhile, acne, hair falling out. I'm 5 feet 2 inches tall. I went from 115 pounds to 160 pounds working out every day. About 30 symptoms of thyroid issues. And I mean, it was a disaster. And what happened to me then is I got— they diagnosed me, misdiagnosed me with polycystic ovarian syndrome. And I always say, it's not that they didn't look at the ultrasound right. You and I would have also called it as PCOS, but no one said, why is a healthy 30-year-old getting gynecological issues when there are none in her family and she's never had an issue? So I didn't have polycystic ovarian syndrome. I had hypothyroidism ignited polycystic ovarian syndrome. And once I fixed my thyroid, Never had an issue, but they were ready to put me on the drugs for it. They were ready to just do that. And I was like, what is going on? There were so many people that were like, take progesterone, take this. I was 30. So I fixed my thyroid and it all went away. Now, I did have to get a polyp removed from my uterus, and I would've loved to have sent the invoice to that uninformed doctor who told me to just work out more and eat less, right? So the thing is, is that the gynecological issues are no joke. And that's, I think, to me, one of the biggest immediate signs of getting your thyroid checked. Absolutely. Other than, you know, you're tired, exhausted, can't lose weight. But you start to have bleeding issues or, or any issues down there or infertility. So that one is just so huge.
Yeah. And it's fascinating because studies show that fertility issues, hormonal issues show up within the ranges that are deemed normal for traditional medicine. And so it could easily, easily fly under the radar and women are left kind of desperate looking for answers on this emotional rollercoaster every month when they're trying to get pregnant, deciding if they should invest tens of thousands of dollars into IVF. And meanwhile, you know, the only thing that's ever been checked on their thyroid is their TSH. It's really so fascinating because I had a similar experience as you in that clinicians will so freely treat things that are secondary to thyroid issues without ever questioning it. I was 27 when my thyroid issue gave me cholesterol issues, and they tried to put me on Lipitor. They did not— they outright Refused to, one, do a full thyroid panel, or two, look at any medication outside of T4. I was on Synthroid at the time, but freely hand out Lipitor to me for the rest of my life. Oh, I can't believe it. For my cholesterol issue, right? That was just a manifestation of my thyroid. It's just, it's so strange.
You know what your level was? Like, there's a woman on my website, Midori. She's a success story who, she's slim and trim like you. She, she didn't actually have the weight gain issue of hypothyroidism, so she didn't like look, you know, I mean, she was feeling awful and exhausted, But her cholesterol was 600.
Oh my goodness.
600. They took the— and she had her testimonial about it on my website, but they took all the tests. They took the heart test, EKG. I mean, they did everything cuz they were like, oh my God. Right? And she was like, what's going on? And they wanted to prescribe her some of these things. And I guess she listened to every podcast I've ever done in my life or whatever it was. And she did her own research, got books, and she treated herself and, you know, went to her doctor and said, this is what I think it is. Okay. Once she got on the right thyroid hormone replacement for her, the right levels, aside from, yes, her brain wakes up, she's happy again. Her cholesterol in 8 months went down to 200 from 600.
Yeah. Oh, I believe that.
I mean, just cholesterol. So that you're a perfect example though, of someone who, where they see that marker and they think, and I don't know if they told you that then, did they say, hey, you need to stop eating red meat? Like, did they question your diet?
They did actually. They told me to stop using olive oil, to start using canola oil and eat less red meat.
Yeah. Oh my God. I don't even know.
I know.
I know.
Wow. It's kind of crazy.
It's canola oil.
Thank God that I was like, thank God you know what you know.
Ugh.
Right. And I didn't know everything I knew back then, but that's what put me on my journey. 'Cause I'm like, so I can't live like this. I knew enough to know the canola oil, olive oil thing was absolutely kind of crazy.
So yeah, I mean, and, and once I found out, how did you get, how did you get better? How did you finally get on the right combination of thyroid hormones to fix and be like, oh, I'm fine now.
I mean, the traditional paradigm— I was already practicing medicine, and the traditional paradigm left me no choice. They said, oh, well, we need to reduce your medication. And I broke down and cried in his office and literally said, if you take anything else from me, I will not be a functioning member of society anymore. Like, the only thing I can do at this point is go to work and then go to bed for 16 hours a day. So if I lose anything else, I won't be able to go to work anymore. So I got on the waitlist. This was a long time ago for one of the only integrative med docs in Austin that kind of specialized in thyroid at the time.
Great.
Saw him. I had a reverse T3, T3 issue, as I'm sure you would imagine. And he changed and put—
Oh, because they kept giving you T4, so they gave you a reverse T3. Yeah.
They're fueling, yeah, a reverse T3 epidemic. And got put on Armour and within a few months I completely got my life back, or at least, you know, the platform to start the rebuilding process that you can't really attain without it.
You can't.
And so that was my journey, thankfully. And that was after years and years of being treated and not doing well and having Hashimoto's, but I just was taken down. And when you have no choice, I mean, that's how most people end up in a different form of medicine. Most people don't go looking for alternative functional, whatever it is, forms of medicine. But like when medicine gives us no choice, it's like, what else are we going to do? So thankfully so many people like you, like me, have taken that experience And now turned our pain into purpose to help other people because there's no end to the amount of women who are just being told it's not their thyroid. It's, let's treat this. They're missing out on the best freaking years of their lives. The best—
Oh my gosh.
It's so good.
It's so good. It was recently, I don't know what had happened. Well, it was like some stuff in our lives. It was a few months ago. My fiancé's mother was dying. She did die and it was just stress was going on. And yeah, it was a rough one. And so I missed my afternoon dose. A couple days in a row. I don't know. I spaced it, whatever, you know?
Yeah.
Just like that, which is unheard of for me. I, you know, I mean, this is like, I'm, you know, clockwork with it. And then it was like, I don't know, it was like maybe I missed 2 or 3 days, probably just 2. But I started, I felt it, I could tell. And I even was like, what is, I was like, oh, oh, I, I missed my afternoon dose. Like, you know, you can tell so quickly. I've also tried to get off thyroid hormone replacement several times. I've done this experiment. One time I thought, oh hey, first 30 days, I was like, I feel pretty good. But then I started to get—
Those adrenals working overtime.
But then I started to get real sick, like real quick, real sick, constipation, puffy eyes, next thing naps every afternoon, next thing general malaise, next thing, oh my God, I'm hypothyroid, like get, no. So anyway, it is such a wonderful life. And once you're over this, the contrast is so wonderful. Most people don't know what it's like to be sick and debilitated and have any kind of empathetic understanding of what chronic illness can be. Once you have felt like this and discounted and dissed for so long, or family members looking at you like you're crazy, that was me. I went to 100 doctors and family members were like, you have to listen to somebody. And I was like, no, I don't. And I'm glad I didn't, McCall, because where would I be if I listened to any of those guys? So it's a very lonely place to be and there's not really a lot of people to talk about. That's why it's great to get involved in your community and people that are also in this. I think one of the things I've seen recently, maybe we should talk about these kind of things. These are things that I see people are misunderstanding. Number one, I see that people are going directly to T3 only when they shouldn't. People are misunderstanding T3 only. They are not understanding that this is the very last choice of thyroid hormone replacement. And while I'm all for it and was on it for many years, and I still take mostly T3, people jump to it because they hear about it. They heard about it somewhere. They heard a podcast. And I've asked that question to many people who come in and have a first call, and I'm like, What was the logic for you to do this? And it's all nonsensical. None of it was like fully researched. So that I find to be an issue. And the other is people just misunderstanding certain things. Like there was a woman that came to me yesterday and she had both low T4 and T3, but she made the comment, she goes, I think I'm having these symptoms from my low T4. And I was like, well, that's not where the symptoms are coming from. But like, so, you know, people will catch a bit or a soundbite.
Yeah.
And then they think they understand, and you really have to learn this feedback loop. You just, it's theoretical, it's not very hard, you just have to give it a shot. And you have to learn it first, and then it has to be repetitive because again, people are latching onto little bits and not understanding how it connects. So I see that mistake being made, going to T3 only, uh, too quickly. The other problem is this, the, like, I had someone call me from Australia and they were like, well, I didn't feel good, so then I took a 5 microgram of slow-release T3, and then 3 hours later I would take another one, and I would just throughout the day, and I'm like, what? Who? I mean, I had a doctor, but I'm like, what are we doing here? People are really misunderstanding slow release versus direct T3, the use of it, how often you should dose. You don't dose thyroid hormones like a Tic Tac, like you feel. The other one too is misgauging exhaustion for hypothyroidism when it's hyperthyroidism.
Yeah.
So there are people that are like, well, I was so tired, so we just did more. And then I was fine and then tired, so I just did more. And I was like, yeah. No, hyperthyroidism is exhausting. Okay? I have accidentally been hyperthyroid by being on too much T3 in my life, and I will say it's exhausting. You know, I talk fast and I'm from downtown Chicago and blah, blah, blah. That's not hyperthyroidism. And sometimes people are thinking like high energy is hyper because of the word. It's not actually. When you're, when you're hyperthyroid, you don't even really wanna be around people. You just don't even wanna deal. And it's a level of inter— it feels awful and you're not talking off, bouncing off the walls like cocaine, and that's the other misinterpretation. People are afraid to, for example, to take a T3 dose in the evening or at night or something for fear of not being able to sleep, when T3 helps you sleep. Now, there are lots of caveats. There are people that are like, I can't take a dose past 5:00 PM or it screws me up. That's fine. But in my experience over all these years, it actually helps you sleep and people are more fearful of that 'cause they think it's like coffee. Do you know what I mean?
Hmm.
So that's another misunderstanding I'd like to clear up. It's not like that and you just don't— Keep taking it like hits of cocaine, or, you know what I mean? That's why it's not a drug of abuse, right?
Right.
Except for bodybuilders, of course.
Yeah, except for bodybuilders. Yes, we could give that caveat for sure. Yeah, I mean, it is— it's a— it's something that's more complex than people medicine, really. It's just nuanced, you know, like it's nuanced. And once you have the tools, it's crazy how effective they are and how quickly they can truly change lives. But it's tricky when people are winging it, when clinicians are winging it, When no one really has the system and the understanding from which to build out plans. And that's why I think now, I mean, I feel so lucky that I ended up finding someone to help me, but nowadays I feel like resources, you, me, so many people in our community are out there trying to share knowledge so freely so that people can navigate this successfully because you kind of have to be able to do that.
And there's millions of people, like there's not enough of us to even cover a fraction of what people are dealing with. There's some other things with thyroid I was thinking of that, like misunderstandings or mishaps.
Yeah.
Um, oh, listen, I like NDT. I'm a fan of natural desiccated thyroid. I think it's one of the most brilliant inventions that that English physician ever came up with. However, it's not better because it's from a pig. There are a lot of people that think it's just better.
Thank you.
Uh, okay. So I've been on both and I can actually, at the end of the day, after 20-something years, I can say I think synthetic's better. Sorry. I mean, it's okay. I don't care if you wanna take Armour, you can take Armour, you can take NP. But it's not better because it's quote natural. It's just not. And so that's a misunderstanding. The other misunderstanding is that someone with Hashimoto's shouldn't take Armour. I've heard that from doctors. Like, that's not necessarily true. So, you know, there's lots of myths to dispel that I hear. I think the biggest one though is the TSH being suppressed. This is a problem and keeps people sick, and I hear about that every day. I mean, every day I am cutting and pasting a version from Dr. Forrestman explaining why And debunking this. That is the number one thing that I see. And let's see, I think the most important, just, you would probably agree with me. I mean, everything I'm saying, I'm, I'm, I know you understand, but if you've had a thyroidectomy, it is 10,000 times more important that you get this right. And it's also more likely that you're with the most uninformed endocrinologist from the very beginning of that process.
Right.
'Cause they're the most indoctrinated and they're handling those surgeries and the aftermath of that. So it is very important. To get it right or you will suffer greatly. And so for the thyroidectomy people, those are the ones that I get. And I know, you know, 'cause they did it to you too, and they do it to probably tons of people that come to you, which is keep throwing T4 at the problem and then creating another thyroid problem. Yep.
Yeah.
Yeah.
And I mean, a couple thoughts. One is the worse you are at using T4, the better your labs are actually going to look to that clinician if they're only checking TSH and T4. It's gonna manipulate that data. So intensely that it's just unreliable. And then the one thing I'm curious if you've noticed that's a little bit of an exception in the thyroid world is I find, you know, look, like if someone comes to see me 30 years into their thyroid journey, I can fix them the same as I could if they saw me on year 1. Like the chances are the same.
Yes.
The weird thing I find is people post-thyroidectomy, the longer they are post-thyroidectomy, The harder it is to get them to feel completely asymptomatic, even if their numbers are perfect, even if we've done all the things that we do with people with an intact thyroid, for some reason in their physiology, something is breaking down over time that's harder and harder to truly give them their highest, you know, sense of vitality back. I don't know if you've ever noticed that.
I think it's trickier. And what I've noticed more is that, at least in the thyroidectomy people that I've dealt with, They tend to do T4 at the beginning of the day with T3, and then T3 the rest of the day. Conversion issues with some of 'em. But I also notice that some of 'em, and it depends on if they have Hashimoto's as well, right? But you know, you can be just passing out and have any of the things. But if you, especially if you don't have that gland, you're really, really, really screwed. And they sometimes need more. They sometimes need way more than like a me or I would. But again, it's so individual, right?
Yeah.
I know a 6-foot-5 guy that's great on 1 grain, and I know A tiny girl that has to take a lot. Like, I know a woman on 400 milligrams of progesterone. I'd be dead. I'd wake up dead with that. I can't even do more than 50 milligrams of progesterone or I'm dizzy and it's awful. So it is so individual. But what I do notice is that I think HRT in menopause and perimenopause is actually harder because there's less patterns and it's even more individual. I think with thyroid it's more straightforward. And like you said, you got fixed in 3, like you spent all this time searching and going through the sea of uninformed doctors, and then it takes 3 months to fix. And you're like, what? Or like you said, 3 months to get to the platform of, now I can detox. Now I can optimize this. Now I can start to really burn deep fat. Or, you know, all of the things you then want to do. I have heard a lot of people say this to me. They're like, oh my God, does this stuff make you happy? Yeah. Yeah, it does. You have more receptors in your brain for T3 than anywhere else. All those neurotransmitters, you just can't even be— you can't access happiness. If someone tries to tell you to do like a gratitude list or Visualize something and you're hypothyroid, it's almost impossible. It's a downer. Absolutely. It's one of the worst things in the whole world. I mean, that's why I always say, like, hypothyroidism messed with the wrong chick. Like, I will take this fucker down. No, Susan Ballard. But you know what I mean? Like, this thing, I just— that's why I'll— and I'm sure why you'll keep talking about it forever, because it's gotta end and people need to get there quicker. And I think that's what we're trying to do. But no one— no situation is hopeless. All it takes is learning a little bit, just a little bit, and getting the right practitioner, whether you work with McCall or me or a You get a doctor who kind of knows what's up and is willing to learn. I find that doctors are being a little bit more open nowadays. I've had other people be cool with their doctors, like I'll leave their doctor messages, they'll go back and forth, and their doctor will practice medicine with them because they're being knowledgeable. And that's the other benefit you get from being one of those patients. The more you're advocating for yourself and learning, then the more your doctor is sort of trusting you to maybe take a shot and practice with you. Not all the time, but sometimes. Yeah.
Yeah. I love that. Well, this was a delightful, insightful conversation. Couple things. It, one, I want you to tell everyone where they can find out more about you, your work, all things El Russ. And 2, I would love for you to close with anything that you feel like maybe we haven't talked about, a message that you want the thyroid community to know that you feel like they deserve to know, or if we've covered it all, sister, that's fine too.
I think we said it earlier where it's like, it's all fixable. There's no reason for anyone to be suffering. That is absolutely true. We're not trying to sell you a snake oil outcome. That really is true. So it's possible. You just have to get there. And I guess my biggest thing is no one cares more about you than you, period. Nobody. I learned that through this. I'm sure you did through that. You can go to as million people as you want, but you are really the one that has to go advocate for yourself. And if you're too exhausted, you gotta get a buddy or a friend or a partner. I get a lot of calls from couples, right? Because one is trying to interpret the information because the other has such bad brain fog. And I'm sure you deal with that too, with husbands and wives and couples. So yeah, I mean, it's the best thing you can do for yourself, your future anti-aging, your brain, your life, and honestly fun. Because if you can't access happy feelings and thoughts, then what is daily life like? It's a downer. And so— You know, you're sort of just surviving. Yeah, you're just surviving. You're not— we want you to be surthriving, right? So you got to learn a little bit about it. You can go to lruss.com for everything thyroid and just click on thyroid solutions. And there's a variety of ways. Um, I wrote The Paleo Thyroid Solution in 2016. I'll have an updated, expanded version of that book next year at some point. And yeah, I've got tools from free, actually just freethyroidguide.com is not only just a free thyroid guide, list of tests, all the kind of juicy stuff, which I'm sure you have too, but it's also a free video series where I do explain how the thyroid feedback loop works. So I know no one wants to learn when you're sick and all of that, but it's the only thing that'll help you get to it sooner, unless you just go call either one of us and then you'll get right to the answers. But yeah, but it's worth it and it doesn't take long. So just keep persevering because perseverance pays. Yeah.
I love that message. And that's the message so many people need to hear. So Thank you for this conversation. Thank you for the work. Thank you for your dedication to these people, these women. They need it. They deserve it. And it's freaking hard to find. So—
You too. You too. Thank you so much.