July 1, 2025 • 34 mins
Struggling with thyroid belly that won't budge despite being told your TSH is "normal" or "optimized"? Dr. Eric Balcavage reveals why 70% of people on thyroid medication were put on it inappropriately and why T3 medication often makes things worse. Discover the difference between homeostasis vs. allostasis and why your cells aren't broken—they're adapting.
Key Topics Covered:
- Why thyroid optimization fails vs. true thyroid recovery
- The cell danger response and allostatic regulation
- Why more T4/T3 medication often worsens symptoms
- Strategic Thyroid Recovery Blueprint approach
- 18 Fitness Factors assessment for root cause analysis
- Escaping "thyroid purgatory" for good
RESOURCES:
Fitness Factor Assessment: DM "fitness" on Instagram @drericbalcavage •
Thyroid Recovery Blueprint: www.drericbalcavage.com
Free Discovery Call: www.drericbalcavage.com
TIMESTAMPS:
- 0:06 - Why thyroid belly persists despite "normal" labs
- 2:44 - Modern thyroid care failures (conventional vs functional)
- 4:22 - SHOCKING: 70% inappropriate thyroid prescriptions
- 8:21 - Blood levels vs cellular physiology disconnect
- 10:29 - HOMEOSTASIS vs ALLOSTASIS explained
- 15:16 - Why doctors fail despite "optimizing" labs
- 17:29 - "Thyroid purgatory" concept
- 18:23 - Why there's no optimal thyroid hormone dose in allostasis
- 21:21 - Strategic Thyroid Recovery Solution
- 22:44 - 18 Fitness Factors assessment (DM "fitness" for free copy)
- 26:39 - Strategic supplementation approach
- 30:07 - T3 medication controversy: 5-10 mcg max
- 32:30 - HOPE: Thyroid belly is NOT a life sentence
- 33:03 - Action steps & free resources
#ThyroidBelly #HypothyroidSymptoms #ThyroidRecovery #CellularHypothyroidism #AllostaticRegulation #StrategicThyroidSolution #ThyroidPurgatory
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Eric Balcavage (00:06):
I'm Dr Eric Balcavage, and we're going to do
a deep dive here, and we'regoing to talk about what is
going on that's preventing youfrom losing your belly weight,
your thyroid belly and yourother hypothyroid signs and
symptoms.
This is often despite taking T4medication and your medical
doctor telling you your TSH isnormal, or your free t4 is
(00:26):
normal, or your thyroidphysiology has been restored.
It can be despite you going tosee a functional or integrative
practitioner and being put on T3medication. Which is what maybe
the integrative or functionalmedicine practitioner told you
was missing is that you hadenough T4 but your doctor didn't
realize that you weren'tconverting T4 to T3. Your body
(00:46):
was favoring the deactivation ofT4 to reverse T3 and that
reverse T3, is blocking your T3from working. Which isn't true,
but it's the justification forthem to then provide T3
medication.
And, it's despite many timesbeing on a gluten-free,
dairy-free, fun-free diet. It'softentimes despite doing
(01:07):
excessive exercise, probablymore than you should be doing
under your current state. Andit's oftentimes despite doing
lots of different supplements tooptimize your gut health,
optimize your detoxificationpathways, optimize your sex
hormones, and optimize yourmitochondrial function.
Does this sound familiar? Doesthis sound like you? It may be
(01:52):
They are on too manysupplements. They are on too
restrictive of a diet for toolong. And, it's also a the same
person who shows up with afrustrated physician who often
looks at the patient withskepticism; like are you taking
the medication? Or are youreally eating well? Or, are you
(02:13):
really exercising? They almostlook at you like they can't
believe that you're doing whatyou should be doing because
they've optimized the lab valuethey care about, and yet you're
still struggling with chronicsigns and symptoms.
But the reason we're doing thispodcast is I want to explain to
(02:35):
you why your efforts aren'tpaying off. Why their best
intentions with medication arenot paying off.
sounding like you if you'relistening to this podcast. This
So first, let's kind of paintthe picture of modern thyroid
care. Modern thyroid care inboth traditional medicine and
functional/integrative medicineis often just a management
(02:58):
strategy. In allopathicmedicine, you go to see your
medical doctor, they run a TSH,and free T4. If TSH is high,
free T4 is low, they'll say,"You have hypothyroidism, we're
going to give you T4 medicationto lower your TSH." "When that's
in the lab range, we've restoredyour thyroid physiology."
And it's a good idea. It's whatthey've been taught. It is what
(03:20):
they've been trained to do. Butit's often not going to restore
thyroid physiology. And when youdon't feel well and function
well, even though they broughtTSH maybe into the 1-2 range,
what typically happens is theyjust keep giving you more
thyroid hormone and they keepdriving TSH lower and lower, and
(03:41):
this creates a couple issues.
One, it suppresses TSH to apoint where there's no way the
thyroid gland can ever recover.
Two, it can up-regulate thesympathetic nervous system
because of the state you're in.
And three, it can actually makethe peripheral conversion of T4
is oftentimes the type of personwho's coming to me, the person
to T3 worse and create morehypothyroid symptoms. At the
(04:02):
same time, that excess thyroidhormone upregulating the
sympathetic nervous system willoften create hyperthyroid
symptoms. And many patients aretold that you can't have both at
the same time. You absolutelycan. Many times, because
somebody's over medicating youwith thyroid medication.
In the integrative andfunctional space, we're not free
(04:27):
of blame here either. We oftenare putting people on medication
who should not be on it. I did apodcast probably last year. We
talked about, I think it waswith Joe El-Khoury, PhD, DABCC,
FACB a clinical chemist, and wetalked about thyroid
(04:49):
prescriptions, and based on hisresearch, he thinks that close
to 70% of the people on thyroidmedication were put on it
inappropriately.
I don't think it's bad intent. Ithink what happens is people are
struggling with hypothyroidsigns and symptoms, and their
(05:11):
TSH is above 2.0 they havesymptoms of hypothyroidism, and
who says, this is me. This ishow I feel. This is how I'm
somebody says, "Well, I'll justgive you thyroid medication and
we'll see if lowers your TSH andmakes you feel better.
And initially, that first hit,maybe does work. But, it doesn't
last because of your state. Andthen you wind up getting on more
T4 medication and more T4medication. And that medication
(05:33):
in your current state, what wecall an Allostatic state, also
starts to suppress TSH too much,suppressing the gland, and now
the gland can't produce T4 orcompensate for the lack of T3
,or the reduced T3 that's beingmade. You wind up on stronger
and stronger doses of thyroidmedication. Despite taking the
T4 medication, you're notconverting the T4 to T3
(05:58):
appropriately.
In integrated and functionalmedicine, we often see the lower
T3 and we think we need to fixit. If somebody has appropriate
T4 in the bloodstream,appropriate free T4 in the
bloodstream, and they're not onmedication, they likely don't
need T3 medication to fix them.That reduce T4 to T3 conversion
(06:24):
should be a sign that there's acell stress, inflammatory
process going on.
functioning. Everybody's tellingme I'm normal or I've been
Your body didn't wake up one dayand forget how to how to convert
T4 to T3. If you see elevatedreverse T3, your body didn't
wake up and say, alright, we'rejust not going to convert T4 to
T3 anymore. We're only going toconvert to reverse T3.
(06:44):
The elevated reverse T3, thelower T3 is an indication of a
cell stress, inflammatory state.And, if we rush in with T3
medication to potentially tryand make the patient feel
better, it can give them the hitor short term feeling good, but
it doesn't restore cellularphysiology. If it did, you'd
(07:05):
feel and function good.
Instead, what it often does isyou get a hit of T3. You feel a
little bit better. And so wethink that's the right strategy
but then it doesn't last becauseof the cellular state. And so,
(07:30):
you wind up on more T3 and youget a benefit. And then it
doesn't last. And then you geton more T3. Now as T3 is going
optimized, and we just can'tfind the magic dose of thyroid
up in this cell stress state, itstarts to saturate the pituitary
(07:54):
and suppress TSH. And now thethyroid gland starts to get shut
down. Now the glands not makinghormone. Now you need more T4 or
you need more T3 depending onwhatever the medicine the
(08:18):
practitioner is providing.
But how do we know that itdoesn't? We know because you
Allostatic regulation. So that'swhat I want to talk about next.
still have thyroid belly, youstill have weight that won't
(08:41):
budge despite restrictive dietand over training and over
exercising. You still havechronic fatigue when you wake up
medication that works.
(09:01):
in the morning. You still havethe 3pm crash. You still fall
asleep within minutes of sittingon the couch to watch TV; many
(09:22):
times, even before the firstcommercials hit. You still have
brain fog. You still havedepression and anxiety and
irritability. You still havesluggish gut function and and
(09:52):
poor hormone regulation.
If somebody manipulated your T4,T3, TSH, rT3 or whatever lab
they care about, into an optimalrange, and it restored thyroid
homeostasis, if it restoredoptimal Cellular physiology, you
wouldn't have thyroid belly. Youwouldn't have chronic weight
gain. You wouldn't have chronicthyroid signs and symptoms. They
(10:16):
would go away. The reason weknow that despite optimizing the
blood level, they haven'toptimized cellular level is
because of your persistent signsand symptoms.
So here's the truth thatpractitioners completely miss,
(10:40):
and that is that we operate inone of two states. One state is
called homeostasis. This is astate where I make enough energy
from the food I take in and fromwhat my body can make to run all
of the systems of the body undermy current stress load. And if
(11:01):
the only issue was that yourgland got destroyed by drugs,
radiation, or surgery, whateverit is, and the gland was
completely shut down anddestroyed, and you're in
homeostasis, and we give you 100micrograms of T4, and 5-10
micrograms of T3, you shouldfeel and function great. You
(11:23):
wouldn't have thyroid belly.You wouldn't have chronic
hypothyroid signs and symptoms.
But if you, if you take thatlevel of medication, and you
still don't feel and functionwell, then it's less about
what's happening in the blood.Because you restored what a
thyroid gland would have made,there should be sufficient
levels in the blood.
And if you say, well, there'senough T4 but I don't have
(11:46):
enough T3 that's not brokenphysiology. That's an adaptive
decreased conversion of T4 toT3. You're in Allostatic
regulation. And, that's whateverybody needs to start to
understand, is that whensomebody has chronic hypothyroid
signs and symptoms, even thoughwe've manipulated their lab
(12:08):
values into range, we have to beaware that there's this cell
stress mechanism going on. Thatthere's reduced peripheral
conversion in the cells andtissues, and more thyroid
hormone won't fix it. Matter offact, many times more thyroid
hormone actually makes the wholesituation worse.
(12:29):
Another thing that's reallyimportant, and many clinicians
don't get this part either, isthat the thyroid gland was never
typically the problem in thefirst place. Sure if you had
your thyroid gland removed orirradiated, the thyroid gland is
a problem. But technically, itstill wasn't the initial
(12:50):
problem. Whatever caused thethyroid dysfunction that
required those types oftreatments was the initial
problem. Oftentimes, the reducedconversion of T4 to T3 and the
thyroiditis, are the effects ofthe cell stress response.
They're not the primary cause.
(13:11):
So if we assume that the primaryreason you have low thyroid
hormone is because the glandjust can't make it, then, yeah,
I understand their strategy. Ifyou assume that your body woke
up one day and forgot how toconvert T4 to T3, then yes, I
could understand the idea thatwe have to give T3. But that's
not really the case, and thishas been written up in the
(13:34):
scientific literature.
When cells perceive stress,danger, low energy, they
adaptively down regulate theirmetabolism. On purpose. They
stiffen their cell membranes topotentially trap an organism or
threat inside the cell, orprevent an organism or threat
(13:55):
from getting into the cell.That's an adaptive response,
unfortunately or fortunately.
The cell stress mechanism ofstiffening the cell membrane
reduces glucose transport,reduces nutrients into the cell.
It also results in reducedproduction of peptides and
(14:17):
hormones or and proteins insidethe cell that makes us not feel
good. But again, that's not partthat's not broken physiology.
That's part of the adaptiveresponse.
What the scientific literatureshows is that when cells
perceive danger, they're notbringing those nutrients in on
purpose so that the organisms orthreat can't use them. They
(14:38):
don't convert amino acids intopeptides, peptides into
proteins, so that the organismor threat can't use it.
There's inflammatory mechanismsthat are initiated within the
cell to protect it, and thensignaling mechanisms released
(14:59):
from those cells in danger, towarn other cells, tissues, the
immune system, for protection.And so what we'relooking and
call dysfunction, is really theadaptive response, at least
early on.
And so this is why, despite yourdoctor's best attempts to
(15:20):
optimize the thyroid lab valuethey care about, they're
unfortunately failing youbecause they're not aware that
you are in a state we callallostasis. And that, despite
their best efforts, more thyroidhormone isn't going to do more
than maybe optimize the labs. Itmay provide some temporary
(15:45):
benefit. But it's not going torestore cellular health and
cellular physiology, because thecells are not in an optimal
metabolic state. They're in thisslowed metabolic state, this pro
inflammatory state that we callthe cell danger response.
The other thing that's reallyimportant here is that when a
(16:07):
cell perceives danger, thehormone that it uses to help
shift from homeostasis toallostasis, to activate all this
cascade of events that occur inthe cell danger response is the
down regulation of T4, to T3that helps slow the metabolism.
(16:28):
It helps reduce themitochondrial function. Many
times people say, you've gotmitochondrial dysfunction. Of
course, you do.
If you have chronic cell stressthat's resulting in the cell
danger response, that'sresulting in a reduced
conversion of T4 to T3, ofcourse there's a down regulation
of mitochondria. But a wholebunch of B vitamins and
mitochondrial supplements aren'tgoing to change that.
(16:51):
Matter of fact, you may not geta lot of those nutrients into
the cell. The body isn't tryingto increase mitochondrial
function. It's trying to downregulate mitochondrial function
on purpose, because if there's acell stress response in the
cell.
Part of the cell trying toprotect itself is creating more
free radicals. If you had freeradicals from the cell danger
(17:13):
response and free radicals fromfull tilt mitochondrial
function, you'd have anexcessive amount of free
radicals that your cell can'tmake enough antioxidants for,
and that would cause more celldamage and cell destruction.
So if you're struggling withchronic hypothyroid signs and
symptoms, if you're strugglingwith thyroid belly, if you're
(17:34):
struggling with not feelingwhere you feel they should be,
like you're stuck between whereyou were without medication and
where you want to be, that'swhat I call thyroid purgatory.
This is a not a great place tobe, because doctors will start
to tell you, Hey, we'veoptimized you. Or we've restored
(17:54):
your thyroid physiology. Butyou're sitting on the other side
saying, I don't feel normal. Idon't feel optimal. I still feel
like I'm hypothyroid. And someof you, because of higher doses
of medication, may actually feelhyperthyroid as well.
So what do we do, like, what'sthe solution here? How do we get
(18:16):
you to recover? How do we getyou to feel and function better?
Well, we have to be aware thatyou're more likely in this
Allostatic regulatory state.You're in this cell stress
physiology. Once you understandthat, then you'll understand why
(18:38):
you can't find the optimal levelof thyroid hormone. Because
there is no optimal level ofthyroid hormone replacement when
you're in this state. Because inthis state, the body wants to
decrease the amount of T4 to T3.There's probably no amount of
medication that's going to makeyou feel well, to feel make you
feel restored. If you're inallostasis, you'll be constantly
(19:01):
trying to manipulate the systemto try and catch the feeling,
and it won't last, even if itgets there short term.
And the other thing that'sreally important is, when you're
in this cell stress physiology,it's not just thyroid hormone
physiology that's in thisAllostatic state, or Allostatic
regulatory state. Many systemswithin the cells are down
(19:25):
regulated;energy production,normal metabolism, normal
hormone production, proteinproduction. Multiple systems
become down regulated. Glucosetransport, down-regulated.
That's why you can't get as muchglucose into the cell, which is
why you're tired. More glucosegets stored as fat, which is why
you gain fat. Liver getsdown-regulated, so you can't
(19:47):
detoxify things as well. Moretoxins are wind up staying in
the body. They have to getstored. They go into fat cells.
Gut physiology getsdown-regulated, because when
you're in cell stress andrunning from the tiger, you're
not going to stop to eat. Sowhat happens? Stomach acid
production goes down. Motilityslows down. Pancreatic enzyme
(20:07):
production goes down. Bile flowgoes down. Now you can't break
down and digest the foods verywell. Now you can't kill the
organisms coming in on yourfood, and they start taking up
residence in the GI tract. Nowyou wind up with imbalances of
the bacteria in your gut. Youwind up with inflammation in the
gut. You wind up with food orfood breakdown and food
(20:27):
reactivity and foodsensitivities and a cascade of
continual problems. Sex hormoneregulation gets down-regulated,
so your cycles become abnormal.You have estrogen imbalances
with progesterone, and you justfeel awful.
Unfortunately, you feel awful.Somebody could say, well, we're
going to optimize your thyroidhormone. Then we're going to
(20:48):
optimize your adrenals withadrenal support. Then we're
going to optimize your sexhormones with bioidentical
hormone replacement. All ofthese things are management
strategies. They're not gettingto the root issue, which is
what's causing this cell stress,cell danger response.
If you don't address that,everything's a management
strategy. You're going to bestuck in thyroid purgatory.
(21:10):
You're going to be stuck withthyroid belly, and you're going
to be stuck with all thesechronic hypothyroid symptoms.
And for many of you,hyperthyroid symptoms as well,
just based on what type ofmedication you're taking.
So what's the strategy forgetting rid of thyroid belly, to
lose weight and improve all ofthese hypothyroid signs and
symptoms? I talk about this inmy strategic thyroid solution
(21:34):
and my thyroid recoveryblueprint. There's a few key
things that have to be done, andthese are things I've been doing
with my clients for working on30 years now.
Number one, we've got todetermine if you're in a
homeostatic state or anallostatic state. I would argue
that if you still don't feelwell, and you've tried lots of
(21:57):
different medication strategies,or you've been told that your
labs have been optimized, andyou still have hypothyroid signs
and symptoms you're inallostasis. You can evaluate
that on your own, but you'reprobably in an allostatic state.
So that's number one.
Once you understand that you'rein an allostatic state, it
(22:19):
changes the game. Now, insteadof wasting time trying to find
the optimal thyroid dose that isgoing to make you feel well,
you're going to realize thatthere isn't an optimal dose
that's going to make you feelwell. Because your body's
adaptively decreasing theproduction of thyroid hormones.
Adaptively decreasing theconversion of T4 to T3. You
don't need to waste as much timetrying to find the magic dose or
(22:40):
the magic supplement that'sgoing to fix you, because it
doesn't exist.
The second thing you have to dois start to identify what's
creating the excessive stressload. This is what I talk about
in the Thyroid Debacle. That'smy book on thyroid physiology
that I wrote with my my friendand colleague, Dr Kelly
Halderman. We talked about thefitness factors in the book. We
put 10 in the book. that Iaddress with clients. We now
(23:03):
assess 18 areas of their health,or what we call fitness factors.
We can give somebody the fitnessfactor questionnaire and have
them complete that, and oncethey complete that, we've got a
pretty good idea of what'scontributing to their excessive
stress load from a habits andlifestyles perspective. Somebody
(23:25):
could start right there. Oncethey know what aspects of their
life they don't have a highlevel of health in; say, your
sleep health is not very good,start working on it. My
respiratory health not verygood. Start working on it. My
mindset health is not very good,start working on it. My
relationships are not very good.Start working on them.
(23:48):
These are the things that arecontributing to the excessive
stress load. We get, oftentimestoo caught up in the shiny
objects; the bacteria, theparasites, the Lyme, the mold,
the yeast, the Candida, thetoxins. We want it to be
something external that got intous that's creating the problem.
(24:08):
And those things do exist, butmore often than not, it's the
life and lifestyle factors thatare creating a heavier load on
the physiology, and then you gota virus, and then you got pushed
into the cell danger response.
The virus comes, it goes, itgoes into dormancy. But because
we had all of this stress in ourlife already, once that virus
(24:34):
gets us into the cell dangerresponse mode, the poor life,
lifestyle habits, behaviors,diet, keep us there. You're
stuck in the allostatic state,and we waste way too much time
and money looking for theorganism or toxin that's the the
guilty party, when many timesthose things have come and gone,
(24:56):
and so the your best money spentis working.
If you want a copy of thefitness factor questionnaire,
you can DM me on Instagram andjust DM me fitness and we'll
send you a copy of the fitnessfactor questionnaire. And you
can do your own self assessment.Once you see what areas you're
(25:18):
the weakest in, and be honestwhen you're scoring yourself,
then you'll know where to startworking.
f you're a person who needs somestructure and doesn't want to
try and figure out. You want toknow how do I improve my Mindset
Fitness on my own? I have aprogram that's like a kind of a
DIY program, where you we giveyou an assessment form for each
(25:41):
of the fitness factors. You do aself assessment, and then
there's support strategies forevery question in the self
assessment. So if you you scoredlow in question one, you scored
a three out of 10. Then there'sasupport strategy for that
question of the things that youcan start to do to improve your
(26:02):
level of fitness in thatcategory. What you need to do is
start slowly and progressivelyworking to improve these
individual fitness factors, andyou're going to start working to
improve your health right away.
So step one to thyroid recoveryand getting out of thyroid
(26:23):
purgatory, is to realize you'reprobably in the allostatic
state. Step two is to assesswhat's contributing to your
excessive stress load and startimproving your level of fitness
in whatever categories youscored poorly in.
Part three of the thyroidrecovery process is to support
(26:44):
the shift back to homeostasis.and we do this not by throwing a
handful of supplements at youand hoping it works. Instead, we
need to be more strategic withour supplemental strategy.
So number one is getting you towork on the fitness factors as
we work on the process strategy.Number two is strategic
(27:08):
supplementation. Not justthrowing a whole bunch of
supplements in there and havingyou on massive quantities of
supplementation, but strategicuse of supplements, a few used
at a time for a specificpurpose. Once we've achieved the
goal with those supplements, wewean those out and layer a few
(27:28):
more on. But this isn'tnecessarily something you should
be doing on your own. You'llwind up taking way too much
supplementation trying to dothis on your own. I would fully
suggest that you work with thefunctional medicine practitioner
to make sure you're doinglimited, targeted, supplemental
strategies to support therecovery and the shift from
(27:50):
allostatic to homeostaticregulation.
What I see especially infunctional medicine, is that
they're using the same strategythat they use for medication,
which is, we're trying tomanipulate a T4 into range, a
TSH, a T3, into range with moreT4, more T3, or more armour,
whatever the medication is. Andthen when they look at a test
(28:12):
and say, Oh, B6 is low, B12 islow, let's just give more B6
more B12. And that's not theappropriate strategy to get
somebody better. We want to usesupplementation strategically to
help restore function andphysiology.
The last part of the supportprocess is making sure that we
(28:34):
are providing the least amountof thyroid hormone support as
possible, so that it'ssupporting the gland's ability
to recover, and supporting anappropriate conversion of T4 to
T3. What many people don'trealize is that if you take too
(28:56):
much T4 medication, and itsuppresses TSH below 2.0 or
below 1.0, that excessive amountof T4 medication suppresses TSH
and inhibits the thyroid glandfrom actually recovering, from
actually doing more work, fromactually making more thyroid
hormone.
If we provide more T4 medicationthan the body needs, and there's
(29:23):
more T4 in the bloodstream thanthe body needs, not only does it
suppress TSH and potentiallysuppress the gland from ever
recovering, it actually reducesthe peripheral conversion of T4
to T3, especially if you havethe cell stress inflammatory
mechanism going on.
So we want to make sure there'senough T4 in the system to to
support the circulation, notnecessarily suppress TSH into a
(29:47):
specific range, but that there'senough T4/ free T4 in
circulation to be available toconvert to T3 if and when the
cells are want to do that. Andthey'll do it. It just won't be
at the same level in allostasisas it would be in homeostasis.
From a T3 perspective, and Iknow a lot of my colleagues
(30:10):
would argue with me, I don'tthink adding to T3 is a great
option if you don't have acompletely destroyed gland. If
there's no thyroid gland becauseit's been removed or irradiated,
the goal is to provide some T3medication. We probably
shouldn't be providing more thanfive to 10 micrograms to replace
(30:32):
what a healthy thyroid glandwould have made.
Yes, more thyroid hormone maychange some signs and symptoms
temporarily and make somebodyfeel better, but taking more T3
medication than a healthythyroid gland would make
actually suppresses TSH,suppresses thyroid gland
production. So it too, caninhibit the thyroid gland from
ever recovering. Plus, T3 canactually create more
(30:58):
inflammation. It can up regulatethe sympathetic nervous system,
it can create more oxidativestress, especially as those
doses go higher and higher. So Idon't think part of the recovery
process should be to optimize T3in the bloodstream.
I think we look at a max 5 to 10micrograms to replace a
(31:18):
destroyed thyroid gland, ifthat's the case, but if you have
a thyroid gland you want torecover, I don't think T3 is
should be part of that recoveryprocess. In most cases, this is
going to really come down to thephysician you're seeing and how
they're treating you, but thisis where a lot of times people
get stuck because their doctorsare busy trying to optimize
(31:39):
their labs as if they're inhomeostasis when they're not.
If you're struggling withchronic hypothyroid signs and
symptoms and sometimeshyperthyroid symptoms, you're in
allostasis. And I think the timespent trying to optimize blood
levels and to manipulate theminto an optimal range is costly.
(32:04):
From a cost perspective, andfrom a time perspective. You'd
be much better off working onthese fitness factors and making
sure you just have enough T4 inthe blood to be able to convert
when the body's cell dangerresponse goes away. You'll
convert more of that T4 to T3.Your body be able to do it. You
were able to do it before youwere diagnosed with
(32:26):
hypothyroidism. You'll be ableto do it, if you address the
cell stress mechanisms.
So here's what I want you towalk away with, this thyroid
belly and this excess weightthat you're struggling with is
not a life sentence. You canrecover from this. The reason
you're storing body fat and notreleasing body fat is because
(32:46):
your body's still in this cellstress, cell danger physiology.
You won't fix this by justadding more thyroid hormone to
the picture. You fix this byaddressing the excessive stress
load, which is what I've talkedabout through this podcast.
If this resonates with resonateswith you and you're looking for
a different strategy, you can goto Instagram and DM me
(33:11):
"fitness", and we'll send youthe fitness factor
questionnaire. You can do yourown self assessment, and then
once you do that selfassessment, you can start
working on the weakest areas onyour own. Go to Google. Go to
your functional medicinepractitioner that you're already
working with and say, hey, theseare the areas I think I need to
work on. What are thestrategies?
If you want some guided help,you can go to my website and you
(33:34):
request my Thyroid RecoveryBlueprint, and in that
blueprint, we give youassessments for all 18 of the
fitness factors and strategiesto improve each of those fitness
factors. And if you're reallystruggling and you really feel
like you need some personalizedhelp, you can go to my profile
in Instagram, or you can go tomy website, DrEricbalcavage.com,
(33:57):
and you can schedule acomplimentary discovery call
where we can talk about what'sgoing on with you and what's the
next logical steps for you.Maybe that might be to work with
me. Maybe it's just, hey, startworking on these fitness
factors. But at least we canhave a discussion and get you on
the right track. So I hope thisThyroid Shorts episode has been
helpful. If you have anyquestions, you can reach out to
(34:20):
me on social media, and you can,as I said, you can go to my
website, DrEricbalcavage.com,and schedule complimentary
discovery call. Take care.
I'm Dr Eric Balcavage, and we're going to do
a deep dive here, and we'regoing to talk about what is
going on that's preventing youfrom losing your belly weight,
your thyroid belly and yourother hypothyroid signs and
symptoms.
This is often despite taking T4medication and your medical
doctor telling you your TSH isnormal, or your free t4 is
(00:26):
normal, or your thyroidphysiology has been restored.
It can be despite you going tosee a functional or integrative
practitioner and being put on T3medication. Which is what maybe
the integrative or functionalmedicine practitioner told you
was missing is that you hadenough T4 but your doctor didn't
realize that you weren'tconverting T4 to T3. Your body
(00:46):
was favoring the deactivation ofT4 to reverse T3 and that
reverse T3, is blocking your T3from working. Which isn't true,
but it's the justification forthem to then provide T3
medication.
And, it's despite many timesbeing on a gluten-free,
dairy-free, fun-free diet. It'softentimes despite doing
(01:07):
excessive exercise, probablymore than you should be doing
under your current state. Andit's oftentimes despite doing
lots of different supplements tooptimize your gut health,
optimize your detoxificationpathways, optimize your sex
hormones, and optimize yourmitochondrial function.
Does this sound familiar? Doesthis sound like you? It may be
(01:52):
They are on too manysupplements. They are on too
restrictive of a diet for toolong. And, it's also a the same
person who shows up with afrustrated physician who often
looks at the patient withskepticism; like are you taking
the medication? Or are youreally eating well? Or, are you
(02:13):
really exercising? They almostlook at you like they can't
believe that you're doing whatyou should be doing because
they've optimized the lab valuethey care about, and yet you're
still struggling with chronicsigns and symptoms.
But the reason we're doing thispodcast is I want to explain to
(02:35):
you why your efforts aren'tpaying off. Why their best
intentions with medication arenot paying off.
sounding like you if you'relistening to this podcast. This
So first, let's kind of paintthe picture of modern thyroid
care. Modern thyroid care inboth traditional medicine and
functional/integrative medicineis often just a management
(02:58):
strategy. In allopathicmedicine, you go to see your
medical doctor, they run a TSH,and free T4. If TSH is high,
free T4 is low, they'll say,"You have hypothyroidism, we're
going to give you T4 medicationto lower your TSH." "When that's
in the lab range, we've restoredyour thyroid physiology."
And it's a good idea. It's whatthey've been taught. It is what
(03:20):
they've been trained to do. Butit's often not going to restore
thyroid physiology. And when youdon't feel well and function
well, even though they broughtTSH maybe into the 1-2 range,
what typically happens is theyjust keep giving you more
thyroid hormone and they keepdriving TSH lower and lower, and
(03:41):
this creates a couple issues.
One, it suppresses TSH to apoint where there's no way the
thyroid gland can ever recover.
Two, it can up-regulate thesympathetic nervous system
because of the state you're in.
And three, it can actually makethe peripheral conversion of T4
is oftentimes the type of personwho's coming to me, the person
to T3 worse and create morehypothyroid symptoms. At the
(04:02):
same time, that excess thyroidhormone upregulating the
sympathetic nervous system willoften create hyperthyroid
symptoms. And many patients aretold that you can't have both at
the same time. You absolutelycan. Many times, because
somebody's over medicating youwith thyroid medication.
In the integrative andfunctional space, we're not free
(04:27):
of blame here either. We oftenare putting people on medication
who should not be on it. I did apodcast probably last year. We
talked about, I think it waswith Joe El-Khoury, PhD, DABCC,
FACB a clinical chemist, and wetalked about thyroid
(04:49):
prescriptions, and based on hisresearch, he thinks that close
to 70% of the people on thyroidmedication were put on it
inappropriately.
I don't think it's bad intent. Ithink what happens is people are
struggling with hypothyroidsigns and symptoms, and their
(05:11):
TSH is above 2.0 they havesymptoms of hypothyroidism, and
who says, this is me. This ishow I feel. This is how I'm
somebody says, "Well, I'll justgive you thyroid medication and
we'll see if lowers your TSH andmakes you feel better.
And initially, that first hit,maybe does work. But, it doesn't
last because of your state. Andthen you wind up getting on more
T4 medication and more T4medication. And that medication
(05:33):
in your current state, what wecall an Allostatic state, also
starts to suppress TSH too much,suppressing the gland, and now
the gland can't produce T4 orcompensate for the lack of T3
,or the reduced T3 that's beingmade. You wind up on stronger
and stronger doses of thyroidmedication. Despite taking the
T4 medication, you're notconverting the T4 to T3
(05:58):
appropriately.
In integrated and functionalmedicine, we often see the lower
T3 and we think we need to fixit. If somebody has appropriate
T4 in the bloodstream,appropriate free T4 in the
bloodstream, and they're not onmedication, they likely don't
need T3 medication to fix them.That reduce T4 to T3 conversion
(06:24):
should be a sign that there's acell stress, inflammatory
process going on.
functioning. Everybody's tellingme I'm normal or I've been
Your body didn't wake up one dayand forget how to how to convert
T4 to T3. If you see elevatedreverse T3, your body didn't
wake up and say, alright, we'rejust not going to convert T4 to
T3 anymore. We're only going toconvert to reverse T3.
(06:44):
The elevated reverse T3, thelower T3 is an indication of a
cell stress, inflammatory state.And, if we rush in with T3
medication to potentially tryand make the patient feel
better, it can give them the hitor short term feeling good, but
it doesn't restore cellularphysiology. If it did, you'd
(07:05):
feel and function good.
Instead, what it often does isyou get a hit of T3. You feel a
little bit better. And so wethink that's the right strategy
but then it doesn't last becauseof the cellular state. And so,
(07:30):
you wind up on more T3 and youget a benefit. And then it
doesn't last. And then you geton more T3. Now as T3 is going
optimized, and we just can'tfind the magic dose of thyroid
up in this cell stress state, itstarts to saturate the pituitary
(07:54):
and suppress TSH. And now thethyroid gland starts to get shut
down. Now the glands not makinghormone. Now you need more T4 or
you need more T3 depending onwhatever the medicine the
(08:18):
practitioner is providing.
But how do we know that itdoesn't? We know because you
Allostatic regulation. So that'swhat I want to talk about next.
still have thyroid belly, youstill have weight that won't
(08:41):
budge despite restrictive dietand over training and over
exercising. You still havechronic fatigue when you wake up
medication that works.
(09:01):
in the morning. You still havethe 3pm crash. You still fall
asleep within minutes of sittingon the couch to watch TV; many
(09:22):
times, even before the firstcommercials hit. You still have
brain fog. You still havedepression and anxiety and
irritability. You still havesluggish gut function and and
(09:52):
poor hormone regulation.
If somebody manipulated your T4,T3, TSH, rT3 or whatever lab
they care about, into an optimalrange, and it restored thyroid
homeostasis, if it restoredoptimal Cellular physiology, you
wouldn't have thyroid belly. Youwouldn't have chronic weight
gain. You wouldn't have chronicthyroid signs and symptoms. They
(10:16):
would go away. The reason weknow that despite optimizing the
blood level, they haven'toptimized cellular level is
because of your persistent signsand symptoms.
So here's the truth thatpractitioners completely miss,
(10:40):
and that is that we operate inone of two states. One state is
called homeostasis. This is astate where I make enough energy
from the food I take in and fromwhat my body can make to run all
of the systems of the body undermy current stress load. And if
(11:01):
the only issue was that yourgland got destroyed by drugs,
radiation, or surgery, whateverit is, and the gland was
completely shut down anddestroyed, and you're in
homeostasis, and we give you 100micrograms of T4, and 5-10
micrograms of T3, you shouldfeel and function great. You
(11:23):
wouldn't have thyroid belly.You wouldn't have chronic
hypothyroid signs and symptoms.
But if you, if you take thatlevel of medication, and you
still don't feel and functionwell, then it's less about
what's happening in the blood.Because you restored what a
thyroid gland would have made,there should be sufficient
levels in the blood.
And if you say, well, there'senough T4 but I don't have
(11:46):
enough T3 that's not brokenphysiology. That's an adaptive
decreased conversion of T4 toT3. You're in Allostatic
regulation. And, that's whateverybody needs to start to
understand, is that whensomebody has chronic hypothyroid
signs and symptoms, even thoughwe've manipulated their lab
(12:08):
values into range, we have to beaware that there's this cell
stress mechanism going on. Thatthere's reduced peripheral
conversion in the cells andtissues, and more thyroid
hormone won't fix it. Matter offact, many times more thyroid
hormone actually makes the wholesituation worse.
(12:29):
Another thing that's reallyimportant, and many clinicians
don't get this part either, isthat the thyroid gland was never
typically the problem in thefirst place. Sure if you had
your thyroid gland removed orirradiated, the thyroid gland is
a problem. But technically, itstill wasn't the initial
(12:50):
problem. Whatever caused thethyroid dysfunction that
required those types oftreatments was the initial
problem. Oftentimes, the reducedconversion of T4 to T3 and the
thyroiditis, are the effects ofthe cell stress response.
They're not the primary cause.
(13:11):
So if we assume that the primaryreason you have low thyroid
hormone is because the glandjust can't make it, then, yeah,
I understand their strategy. Ifyou assume that your body woke
up one day and forgot how toconvert T4 to T3, then yes, I
could understand the idea thatwe have to give T3. But that's
not really the case, and thishas been written up in the
(13:34):
scientific literature.
When cells perceive stress,danger, low energy, they
adaptively down regulate theirmetabolism. On purpose. They
stiffen their cell membranes topotentially trap an organism or
threat inside the cell, orprevent an organism or threat
(13:55):
from getting into the cell.That's an adaptive response,
unfortunately or fortunately.
The cell stress mechanism ofstiffening the cell membrane
reduces glucose transport,reduces nutrients into the cell.
It also results in reducedproduction of peptides and
(14:17):
hormones or and proteins insidethe cell that makes us not feel
good. But again, that's not partthat's not broken physiology.
That's part of the adaptiveresponse.
What the scientific literatureshows is that when cells
perceive danger, they're notbringing those nutrients in on
purpose so that the organisms orthreat can't use them. They
(14:38):
don't convert amino acids intopeptides, peptides into
proteins, so that the organismor threat can't use it.
There's inflammatory mechanismsthat are initiated within the
cell to protect it, and thensignaling mechanisms released
(14:59):
from those cells in danger, towarn other cells, tissues, the
immune system, for protection.And so what we'relooking and
call dysfunction, is really theadaptive response, at least
early on.
And so this is why, despite yourdoctor's best attempts to
(15:20):
optimize the thyroid lab valuethey care about, they're
unfortunately failing youbecause they're not aware that
you are in a state we callallostasis. And that, despite
their best efforts, more thyroidhormone isn't going to do more
than maybe optimize the labs. Itmay provide some temporary
(15:45):
benefit. But it's not going torestore cellular health and
cellular physiology, because thecells are not in an optimal
metabolic state. They're in thisslowed metabolic state, this pro
inflammatory state that we callthe cell danger response.
The other thing that's reallyimportant here is that when a
(16:07):
cell perceives danger, thehormone that it uses to help
shift from homeostasis toallostasis, to activate all this
cascade of events that occur inthe cell danger response is the
down regulation of T4, to T3that helps slow the metabolism.
(16:28):
It helps reduce themitochondrial function. Many
times people say, you've gotmitochondrial dysfunction. Of
course, you do.
If you have chronic cell stressthat's resulting in the cell
danger response, that'sresulting in a reduced
conversion of T4 to T3, ofcourse there's a down regulation
of mitochondria. But a wholebunch of B vitamins and
mitochondrial supplements aren'tgoing to change that.
(16:51):
Matter of fact, you may not geta lot of those nutrients into
the cell. The body isn't tryingto increase mitochondrial
function. It's trying to downregulate mitochondrial function
on purpose, because if there's acell stress response in the
cell.
Part of the cell trying toprotect itself is creating more
free radicals. If you had freeradicals from the cell danger
(17:13):
response and free radicals fromfull tilt mitochondrial
function, you'd have anexcessive amount of free
radicals that your cell can'tmake enough antioxidants for,
and that would cause more celldamage and cell destruction.
So if you're struggling withchronic hypothyroid signs and
symptoms, if you're strugglingwith thyroid belly, if you're
(17:34):
struggling with not feelingwhere you feel they should be,
like you're stuck between whereyou were without medication and
where you want to be, that'swhat I call thyroid purgatory.
This is a not a great place tobe, because doctors will start
to tell you, Hey, we'veoptimized you. Or we've restored
(17:54):
your thyroid physiology. Butyou're sitting on the other side
saying, I don't feel normal. Idon't feel optimal. I still feel
like I'm hypothyroid. And someof you, because of higher doses
of medication, may actually feelhyperthyroid as well.
So what do we do, like, what'sthe solution here? How do we get
(18:16):
you to recover? How do we getyou to feel and function better?
Well, we have to be aware thatyou're more likely in this
Allostatic regulatory state.You're in this cell stress
physiology. Once you understandthat, then you'll understand why
(18:38):
you can't find the optimal levelof thyroid hormone. Because
there is no optimal level ofthyroid hormone replacement when
you're in this state. Because inthis state, the body wants to
decrease the amount of T4 to T3.There's probably no amount of
medication that's going to makeyou feel well, to feel make you
feel restored. If you're inallostasis, you'll be constantly
(19:01):
trying to manipulate the systemto try and catch the feeling,
and it won't last, even if itgets there short term.
And the other thing that'sreally important is, when you're
in this cell stress physiology,it's not just thyroid hormone
physiology that's in thisAllostatic state, or Allostatic
regulatory state. Many systemswithin the cells are down
(19:25):
regulated;energy production,normal metabolism, normal
hormone production, proteinproduction. Multiple systems
become down regulated. Glucosetransport, down-regulated.
That's why you can't get as muchglucose into the cell, which is
why you're tired. More glucosegets stored as fat, which is why
you gain fat. Liver getsdown-regulated, so you can't
(19:47):
detoxify things as well. Moretoxins are wind up staying in
the body. They have to getstored. They go into fat cells.
Gut physiology getsdown-regulated, because when
you're in cell stress andrunning from the tiger, you're
not going to stop to eat. Sowhat happens? Stomach acid
production goes down. Motilityslows down. Pancreatic enzyme
(20:07):
production goes down. Bile flowgoes down. Now you can't break
down and digest the foods verywell. Now you can't kill the
organisms coming in on yourfood, and they start taking up
residence in the GI tract. Nowyou wind up with imbalances of
the bacteria in your gut. Youwind up with inflammation in the
gut. You wind up with food orfood breakdown and food
(20:27):
reactivity and foodsensitivities and a cascade of
continual problems. Sex hormoneregulation gets down-regulated,
so your cycles become abnormal.You have estrogen imbalances
with progesterone, and you justfeel awful.
Unfortunately, you feel awful.Somebody could say, well, we're
going to optimize your thyroidhormone. Then we're going to
(20:48):
optimize your adrenals withadrenal support. Then we're
going to optimize your sexhormones with bioidentical
hormone replacement. All ofthese things are management
strategies. They're not gettingto the root issue, which is
what's causing this cell stress,cell danger response.
If you don't address that,everything's a management
strategy. You're going to bestuck in thyroid purgatory.
(21:10):
You're going to be stuck withthyroid belly, and you're going
to be stuck with all thesechronic hypothyroid symptoms.
And for many of you,hyperthyroid symptoms as well,
just based on what type ofmedication you're taking.
So what's the strategy forgetting rid of thyroid belly, to
lose weight and improve all ofthese hypothyroid signs and
symptoms? I talk about this inmy strategic thyroid solution
(21:34):
and my thyroid recoveryblueprint. There's a few key
things that have to be done, andthese are things I've been doing
with my clients for working on30 years now.
Number one, we've got todetermine if you're in a
homeostatic state or anallostatic state. I would argue
that if you still don't feelwell, and you've tried lots of
(21:57):
different medication strategies,or you've been told that your
labs have been optimized, andyou still have hypothyroid signs
and symptoms you're inallostasis. You can evaluate
that on your own, but you'reprobably in an allostatic state.
So that's number one.
Once you understand that you'rein an allostatic state, it
(22:19):
changes the game. Now, insteadof wasting time trying to find
the optimal thyroid dose that isgoing to make you feel well,
you're going to realize thatthere isn't an optimal dose
that's going to make you feelwell. Because your body's
adaptively decreasing theproduction of thyroid hormones.
Adaptively decreasing theconversion of T4 to T3. You
don't need to waste as much timetrying to find the magic dose or
(22:40):
the magic supplement that'sgoing to fix you, because it
doesn't exist.
The second thing you have to dois start to identify what's
creating the excessive stressload. This is what I talk about
in the Thyroid Debacle. That'smy book on thyroid physiology
that I wrote with my my friendand colleague, Dr Kelly
Halderman. We talked about thefitness factors in the book. We
put 10 in the book. that Iaddress with clients. We now
(23:03):
assess 18 areas of their health,or what we call fitness factors.
We can give somebody the fitnessfactor questionnaire and have
them complete that, and oncethey complete that, we've got a
pretty good idea of what'scontributing to their excessive
stress load from a habits andlifestyles perspective. Somebody
(23:25):
could start right there. Oncethey know what aspects of their
life they don't have a highlevel of health in; say, your
sleep health is not very good,start working on it. My
respiratory health not verygood. Start working on it. My
mindset health is not very good,start working on it. My
relationships are not very good.Start working on them.
(23:48):
These are the things that arecontributing to the excessive
stress load. We get, oftentimestoo caught up in the shiny
objects; the bacteria, theparasites, the Lyme, the mold,
the yeast, the Candida, thetoxins. We want it to be
something external that got intous that's creating the problem.
(24:08):
And those things do exist, butmore often than not, it's the
life and lifestyle factors thatare creating a heavier load on
the physiology, and then you gota virus, and then you got pushed
into the cell danger response.
The virus comes, it goes, itgoes into dormancy. But because
we had all of this stress in ourlife already, once that virus
(24:34):
gets us into the cell dangerresponse mode, the poor life,
lifestyle habits, behaviors,diet, keep us there. You're
stuck in the allostatic state,and we waste way too much time
and money looking for theorganism or toxin that's the the
guilty party, when many timesthose things have come and gone,
(24:56):
and so the your best money spentis working.
If you want a copy of thefitness factor questionnaire,
you can DM me on Instagram andjust DM me fitness and we'll
send you a copy of the fitnessfactor questionnaire. And you
can do your own self assessment.Once you see what areas you're
(25:18):
the weakest in, and be honestwhen you're scoring yourself,
then you'll know where to startworking.
f you're a person who needs somestructure and doesn't want to
try and figure out. You want toknow how do I improve my Mindset
Fitness on my own? I have aprogram that's like a kind of a
DIY program, where you we giveyou an assessment form for each
(25:41):
of the fitness factors. You do aself assessment, and then
there's support strategies forevery question in the self
assessment. So if you you scoredlow in question one, you scored
a three out of 10. Then there'sasupport strategy for that
question of the things that youcan start to do to improve your
(26:02):
level of fitness in thatcategory. What you need to do is
start slowly and progressivelyworking to improve these
individual fitness factors, andyou're going to start working to
improve your health right away.
So step one to thyroid recoveryand getting out of thyroid
(26:23):
purgatory, is to realize you'reprobably in the allostatic
state. Step two is to assesswhat's contributing to your
excessive stress load and startimproving your level of fitness
in whatever categories youscored poorly in.
Part three of the thyroidrecovery process is to support
(26:44):
the shift back to homeostasis.and we do this not by throwing a
handful of supplements at youand hoping it works. Instead, we
need to be more strategic withour supplemental strategy.
So number one is getting you towork on the fitness factors as
we work on the process strategy.Number two is strategic
(27:08):
supplementation. Not justthrowing a whole bunch of
supplements in there and havingyou on massive quantities of
supplementation, but strategicuse of supplements, a few used
at a time for a specificpurpose. Once we've achieved the
goal with those supplements, wewean those out and layer a few
(27:28):
more on. But this isn'tnecessarily something you should
be doing on your own. You'llwind up taking way too much
supplementation trying to dothis on your own. I would fully
suggest that you work with thefunctional medicine practitioner
to make sure you're doinglimited, targeted, supplemental
strategies to support therecovery and the shift from
(27:50):
allostatic to homeostaticregulation.
What I see especially infunctional medicine, is that
they're using the same strategythat they use for medication,
which is, we're trying tomanipulate a T4 into range, a
TSH, a T3, into range with moreT4, more T3, or more armour,
whatever the medication is. Andthen when they look at a test
(28:12):
and say, Oh, B6 is low, B12 islow, let's just give more B6
more B12. And that's not theappropriate strategy to get
somebody better. We want to usesupplementation strategically to
help restore function andphysiology.
The last part of the supportprocess is making sure that we
(28:34):
are providing the least amountof thyroid hormone support as
possible, so that it'ssupporting the gland's ability
to recover, and supporting anappropriate conversion of T4 to
T3. What many people don'trealize is that if you take too
(28:56):
much T4 medication, and itsuppresses TSH below 2.0 or
below 1.0, that excessive amountof T4 medication suppresses TSH
and inhibits the thyroid glandfrom actually recovering, from
actually doing more work, fromactually making more thyroid
hormone.
If we provide more T4 medicationthan the body needs, and there's
(29:23):
more T4 in the bloodstream thanthe body needs, not only does it
suppress TSH and potentiallysuppress the gland from ever
recovering, it actually reducesthe peripheral conversion of T4
to T3, especially if you havethe cell stress inflammatory
mechanism going on.
So we want to make sure there'senough T4 in the system to to
support the circulation, notnecessarily suppress TSH into a
(29:47):
specific range, but that there'senough T4/ free T4 in
circulation to be available toconvert to T3 if and when the
cells are want to do that. Andthey'll do it. It just won't be
at the same level in allostasisas it would be in homeostasis.
From a T3 perspective, and Iknow a lot of my colleagues
(30:10):
would argue with me, I don'tthink adding to T3 is a great
option if you don't have acompletely destroyed gland. If
there's no thyroid gland becauseit's been removed or irradiated,
the goal is to provide some T3medication. We probably
shouldn't be providing more thanfive to 10 micrograms to replace
(30:32):
what a healthy thyroid glandwould have made.
Yes, more thyroid hormone maychange some signs and symptoms
temporarily and make somebodyfeel better, but taking more T3
medication than a healthythyroid gland would make
actually suppresses TSH,suppresses thyroid gland
production. So it too, caninhibit the thyroid gland from
ever recovering. Plus, T3 canactually create more
(30:58):
inflammation. It can up regulatethe sympathetic nervous system,
it can create more oxidativestress, especially as those
doses go higher and higher. So Idon't think part of the recovery
process should be to optimize T3in the bloodstream.
I think we look at a max 5 to 10micrograms to replace a
(31:18):
destroyed thyroid gland, ifthat's the case, but if you have
a thyroid gland you want torecover, I don't think T3 is
should be part of that recoveryprocess. In most cases, this is
going to really come down to thephysician you're seeing and how
they're treating you, but thisis where a lot of times people
get stuck because their doctorsare busy trying to optimize
(31:39):
their labs as if they're inhomeostasis when they're not.
If you're struggling withchronic hypothyroid signs and
symptoms and sometimeshyperthyroid symptoms, you're in
allostasis. And I think the timespent trying to optimize blood
levels and to manipulate theminto an optimal range is costly.
(32:04):
From a cost perspective, andfrom a time perspective. You'd
be much better off working onthese fitness factors and making
sure you just have enough T4 inthe blood to be able to convert
when the body's cell dangerresponse goes away. You'll
convert more of that T4 to T3.Your body be able to do it. You
were able to do it before youwere diagnosed with
(32:26):
hypothyroidism. You'll be ableto do it, if you address the
cell stress mechanisms.
So here's what I want you towalk away with, this thyroid
belly and this excess weightthat you're struggling with is
not a life sentence. You canrecover from this. The reason
you're storing body fat and notreleasing body fat is because
(32:46):
your body's still in this cellstress, cell danger physiology.
You won't fix this by justadding more thyroid hormone to
the picture. You fix this byaddressing the excessive stress
load, which is what I've talkedabout through this podcast.
If this resonates with resonateswith you and you're looking for
a different strategy, you can goto Instagram and DM me
(33:11):
"fitness", and we'll send youthe fitness factor
questionnaire. You can do yourown self assessment, and then
once you do that selfassessment, you can start
working on the weakest areas onyour own. Go to Google. Go to
your functional medicinepractitioner that you're already
working with and say, hey, theseare the areas I think I need to
work on. What are thestrategies?
If you want some guided help,you can go to my website and you
(33:34):
request my Thyroid RecoveryBlueprint, and in that
blueprint, we give youassessments for all 18 of the
fitness factors and strategiesto improve each of those fitness
factors. And if you're reallystruggling and you really feel
like you need some personalizedhelp, you can go to my profile
in Instagram, or you can go tomy website, DrEricbalcavage.com,
(33:57):
and you can schedule acomplimentary discovery call
where we can talk about what'sgoing on with you and what's the
next logical steps for you.Maybe that might be to work with
me. Maybe it's just, hey, startworking on these fitness
factors. But at least we canhave a discussion and get you on
the right track. So I hope thisThyroid Shorts episode has been
helpful. If you have anyquestions, you can reach out to
(34:20):
me on social media, and you can,as I said, you can go to my
website, DrEricbalcavage.com,and schedule complimentary
discovery call. Take care.
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