October 1, 2024 โข 28 mins
Welcome to Season 3 of the Essence of Health Tea Time podcast!
Thyroid disorders are among the most common endocrine conditions, affecting millions of people worldwide. Studies have shown that up to 60% of the population may have some form of thyroid dysfunction that they are totally unaware of.
This month on The Essence of Health Tea Time podcast, we'll have a two-part episode with guest, Dr. Dana Gibbs. On today's episode, Dr. Shayla and Dr. Dana will be spilling "๐๐ก๐ ๐๐๐ ๐๐ง ๐๐จ๐ฎ๐ซ ๐๐ก๐ฒ๐ซ๐จ๐ข๐ - ๐๐๐ฌ๐ญ๐ข๐ง๐ , ๐๐จ๐ฑ๐ข๐ง๐ฌ, ๐๐ง๐ ๐๐ซ๐ฎ๐ญ๐ก - ๐๐๐ซ๐ญ ๐".
Dr. Dana Gibbs is a board-certified otolaryngologist, thyroid surgeon, and founder of Consultants in Metabolism. She specializes in the medical treatment of Hashimoto's disease and other complex thyroid-related illnesses and chronic fatigue. Dr. Gibbs helps patients who have not responded to levothyroxine or who were not offered treatment due to normal TSH regain their energy and vitality.
Synopsis:
- Discover the most common thyroid disorders and their typical symptoms.
- Learn about often-overlooked symptoms of thyroid dysfunction that might surprise you.
- Understand why TSH alone isn't enough and explore the comprehensive thyroid testing approach Dr. Gibbs uses.
- Gain insights into the intricate balance of your thyroid hormones and how other thyroid tests may be helpful.
- Get the "thyroid tea" on how proper thyroid balance affects everything from weight management to brain function.
- Stay tuned next week to hear part 2 of this episode...
Connect with Essence of Health at www.DrShayla.com/EOH
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โ-----------------------------------------------------------------
Connect with Dr. Dana Gibbs:
Website: https://www.danagibbsmd.com/
Facebook: https://www.facebook.com/consultantsinmetabolism
Instagram: @danagibbsmd
YouTube: @danagibbsmd8190
TikTok: @dana.gibbs.md
LinkedIn: https://www.linkedin.com/in/danagibbsmd/
Podcast: โBeyond The Thyroidโ https://www.buzzsprout.com/2373989
The Essence of Health is in You!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to the Essence of Health Tea Time Podcast.
(00:12):
I am your host, Dr. Shayla Toons-Whithers.
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases.
It's tea time!
(00:36):
What part of your health journey is most challenging?
Is it the actual effort of sticking to a plan?
The cooking and the meal planning?
The exercise routine?
Not enough time for everything you think you need to do?
Or the confusion of it all?
If you said yes to any of these obstacles, then keep listening to learn how you can smash
(01:00):
these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring?
Well, I have news for you.
You can improve your health, get a jump start on improving your health conditions, and start
(01:20):
to feel like a better version of you just by checking your email inbox over the next
5 days when you join the free Nourish and Flourish 5 Day Challenge.
You'll get health tips, actionable videos, a goal and habit tracker, and healthy recipes
every day for 5 days.
(01:41):
Better health is the best investment you'll ever make, and this is only a small investment
of your time.
You have nothing to lose, but everything to gain.
The Nourish and Flourish 5 Day Challenge was designed to set the foundation for healthy
habits for life.
Say yes to yourself today and sign up now at drshayla.com forward slash nfchallenge.
(02:06):
I'll also place these details in the show notes.
The essence of health is in you.
See you in your inbox.
On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
Dr. Dana Gibbs.
Dr. Gibbs is a board certified otolaryngologist, thyroid surgeon, and founder of Consultants
(02:28):
in Metabolism, a practice focused on the medical treatment of Hashimoto's disease,
and other complex thyroid-related illnesses and chronic fatigue.
She helps patients who have not responded to levothyroxine or who were not offered treatment
due to normal TSH regain their energy and vitality.
(02:48):
Welcome to the show, Dr. Gibbs.
I'm just ecstatic to have you on the show.
Oh, thank you for having me.
I'm really excited to be here.
This is going to be so much fun.
Yeah, it will be.
So we'll just kick this off with you just telling me, even within your practice, what
are some of those more common thyroid disorders you encounter?
And then what do typically people experience?
(03:10):
Like when they come to you, what kind of things are they experiencing in terms of symptoms?
Okay, sure, absolutely.
So I would say number one most common thing that I see people for is for Hashimoto's disease,
which is an autoimmune condition that attacks your thyroid gland and can cause you to have
(03:33):
either too much thyroid hormone or not enough thyroid hormone circulating in your body at
any given time.
And that fluctuation makes people feel really, really bad.
The other thing that I tend to see people for are other benign thyroid conditions.
Say they have a thyroid nodule that was caused by they don't know what or Graves' disease,
(03:57):
which is a different autoimmune condition, or maybe they've had surgery or they've had
radiation treatment and then they were given medication afterwards to replace their thyroid
hormone and they just don't feel well.
So those are super common things that I see people for.
The common thread running through it for everybody, and not everybody has thyroid problems, but
(04:23):
all my patients have fatigue and sometimes just crushing, debilitating fatigue.
And that tends to be what brings them in.
And they say, okay, I'm giving up on the standard treatment.
I want to try something outside the box.
I'm going to go see this person, which is me.
(04:44):
Yeah, yeah, I can imagine.
So in family medicine, we do tend to see a lot of the fatigue or even weight gain that
folks are commonly presenting with.
And then it's one of those things where if the thyroid does turn out to be perfectly
normal, they're like, oh, I was almost wishing it was my thyroid.
And those are the people that I see and those are the people that I want to see.
(05:08):
Because we have this idea in medicine that this one test, the TSH test is kind of like
the buck stops here.
And if that's fine, then nothing else can be wrong.
And what I've found over the course of years, and it was true for my own health, which is
where I started with it, was that it's not always fine when the TSH is normal.
(05:33):
Yeah.
Tell us a bit more about that.
Okay.
So my personal story was kind of the story of everybody who goes through medical training.
I mean, it's grueling, it's intense, it's long, it just goes on and on and on.
And when I was making the decision to even go to medical school, I was very hesitant
(05:59):
because even starting in about high school, I had started being really tired all the time.
And I didn't know what was wrong with me.
I didn't know that anything was wrong with me.
I just thought, I'm a teenager, I'm tired all the time.
But when I got to college and I got to my senior year of college and it's time to make
(06:19):
that decision, okay, I'm going to go to med school or I'm not going to go to med school,
I'm going to do something else.
I at first chose not to because I thought, I've heard how bad it is.
I don't think I can do it.
I was already that tired.
Yeah, put that in your mind.
Yeah, I mean, it was in my mind that I can't do this.
(06:43):
And then I went out and I tried, I got a job in a science lab and I did that for a while
and I was like, okay, I'm bored.
I'm really meant to be a doctor.
Since I was 10, I wanted to be a surgeon, a heart surgeon or a brain surgeon or something
stupid like that.
I don't know.
But I knew that's what I needed to do all along and I was just dragging my feet and
(07:08):
going, oh, okay, I'm not going to do it.
But then I was like, okay, fine, going to go to med school.
And sure enough, it was, wow, I couldn't have even imagined how hard it was going to be.
It was hard.
And I got on the wards and I got to where I couldn't stay standing up.
(07:30):
I was going to pass out.
I mean, I was having fainting spells on the wards.
I would kneel down in the hall outside a patient's room and take an E and the resident was just
like, well, you're unprofessional, blah, blah, blah.
I was like, Luke, I'm getting ready to pass.
Oh, dude.
(07:51):
And I wasn't assertive enough to defend myself.
I just looked like a lazy whatever in front of all these people.
You're not really allowed to be you're not allowed.
You're not allowed to take time off to show weakness.
You're not allowed to show anything.
But anyway, so I went to the health clinic and I said, hey, I think something's wrong
(08:14):
with me.
I'm nearly passing out on rounds.
What's going on?
And they did some tests and my TSH was fine.
And they said, here, try these antidepressants.
You know, I mean, it's just the thing.
That's what happens.
Right.
And I was like, OK, I'm taking the antidepressants.
They didn't really help.
(08:35):
But maybe that's just who I am.
And I just going to have to use more willpower and try harder, you know, and just put up
with the fact that I'm exhausted all the time.
And I did.
And I went on to residency.
And thank goodness I did E and T and not general surgery because I probably would have died.
(08:56):
You know, I did.
Yeah, I did a year of general surgery and, you know, it was it became close to killing
me.
I don't know.
But the fatigue just kept getting worse and it kept getting worse and kept getting worse.
And I managed to graduate my residency and get out and come home to my mom in my hometown
(09:17):
and get a job here.
And, you know, instead of some going on to some big fancy academic career, because I
was just so tired.
I couldn't think of doing anything else.
And I mean, this is by now almost 20 years of being tired, 20 years.
And I was at a lecture one day, I was at a continuing ed lecture one day, and I had gone
(09:40):
into.
I was there to learn allergy.
That was kind of my thing.
That was that was, you know, E and T and learning allergy because it affects your sinuses and
all that.
And I had heard the lecture before and I was bored.
So I wandered into the next room.
You know how sometimes they have different sessions going on at the same time.
(10:01):
And the lecture was about thyroid.
And the guy put up this slide with all this list of symptoms symptoms.
And by the end of it, my jaw was on the floor.
I was like, holy cow, I have hypothyroidism.
Why didn't anybody ever figure this out?
And of course, they didn't because my TSH was fine.
(10:22):
Nobody dug any deeper.
Nobody dug any deeper.
Nobody knew to dig any deeper.
Most people still don't know.
Right.
But but I went home and I did what that guy said.
And I tried the medicine regimen that he said.
And it was like this miracle.
All of a sudden, I have energy.
All of a sudden, I'm not freezing all the time.
All of a sudden, my hair started to grow back.
(10:44):
My eyebrows started to grow back.
I was like, what is this?
Is this what normal people are like?
Really?
Wow.
You know.
And you know, when I first started on it, I didn't care why it worked.
I didn't care that it made my labs look messed up.
All I cared about was that I felt better.
All I cared about.
(11:04):
But then after I'd been feeling better for a while and I started noticing that same list
of symptoms in my patients, I was like, OK, I can experiment on me, but I can't experiment
on my patients.
I have to know what's going on.
Why does this work?
What's a better way to deal with it?
And so I started looking and eventually found the information that I was looking for.
(11:27):
It's not mainstream, but it is super helpful.
And patient after patient would come in to me and they'd be like, yeah, I've got all
these sinus disease, but I'm also cold and tired and sick and I've had four miscarriages
and blah, blah, blah.
And I'm like, let me see if I can help you.
And I would do what I had learned, which we can talk about.
(11:49):
And people would get better and they would come back and they were like, Doc, I'm pregnant.
I'm going to have a baby.
You know, and I'm wow.
Even just to piggyback off of that, what would you say are some of those most overlooked
symptoms of thyroid dysfunction?
You know, you mentioned with like the fertility issues, but what are those other ones would
(12:10):
you say?
Right.
So, so yeah, first, first is irregular periods and then infertility, repeated miscarriages.
That's a biggie, but there are other symptoms.
There are like, for example, constipation.
I have, I have, um, this is not my patient.
She's a friend of mine who had constipation that was so bad, didn't respond to any other
(12:34):
kinds of treatment, never had an abnormal TSH test.
And I mean, this lady went to the Mayo clinic.
She went to all kinds, you know, all kinds of places.
And then she got pregnant and her GYN gave her thyroid medicine and all of a sudden her
constipation was boom.
It was gone and was like, what?
(12:57):
I mean, she had colon surgery.
Oh my goodness.
Because of this.
I mean, that's how bad it was.
Yeah.
And so, and it was just unrecognized, you know, and, and people think, oh, constipation,
it's a little uncomfortable.
Well, not for her.
It wasn't.
It was, it was life destroy.
(13:17):
It was a life destroying thing for her.
Um, and the surgery that she had that turned out not actually probably to be necessary
is something she can not undo, you know, it's never, um, so that's another one.
And then there are some weird immunological things like people who are sick all the time
who get virus after virus after virus, sinus infection after sinus infection.
(13:42):
Most people it's, you know, and I saw them all the time because I was ENT, I was doing
allergy, I was doing sinus surgery.
They would come in and they'd be like, oh, you know what?
It's six months until I can take time off to have my sinus surgery.
Um, and I'd say, well, you know, Hey, you have these symptoms.
Let's try thyroid treatment for you.
(14:04):
Um, six months later they'd be back and I'd be like, okay, we're ready to schedule your
surgery and it'd be like, oh no, I don't need that.
I'm fine.
I just need more of that thyroid medicine.
It was like, boom, boom.
What is going on here?
This is something real.
Yeah.
So, so that's another big one.
Just the immune issues that go with it.
(14:26):
People don't think about that.
You know, they think about that, you know, we do know that thyroid is an autoimmune,
um, condition.
And so that does make sense too, that you would have other immunological, uh, things
going along with it.
Sure.
And then another that goes kind of along those lines are some weird immune things like vertigo
(14:49):
and chronic urticaria, like hives that come and go and come and go for no apparent reason,
dry itchy skin, hair loss.
You know, I talked to a lot of dermatologists and I'm like, look, I can help your patients
who are losing their hair.
And you know, it's, it's, um, you know, it's not an instantaneous thing, but it's, it's
(15:12):
pretty remarkable when people are like, doc, I have all these little fuzzy hairs growing.
I'm like, I know, I know.
It's really, it's really kind of, um, it's kind of gratifying.
I like it.
Right.
Yeah, I'm sure.
Yeah.
So, so many different symptoms.
If you're frustrated with your weight, taking more medications than you'd like to, have
(15:33):
been told that you are at risk for the development of a chronic preventable disease or just are
not feeling in the best of health, then I'm talking to you.
Why?
Because you're tired of fat dieting.
You know, it's time for a change and you want a sustainable plan to improve your health.
If you have found yourself at this place in life, well, I have developed a program that's
(15:56):
just for you.
It's called the Essence of Health and it's your prescription for transformation.
My goal with this program is to give you the tools needed to create sustainable lifestyle
changes within a group coaching setting, along with one-to-one individualized coaching to
give you a personalized path to health that's just for you.
(16:19):
The benefits are priceless.
So join today.
Head on over to eohcoaching.com to learn more.
The Essence of Health is in you.
And so you mentioned that a lot of times we tend to just hone in on the TSH and, you know,
don't look any further.
So what types of things should be looked at beyond that TSH?
(16:43):
Sure.
So I always, you know, I mean, the patients that come to me have self-selected for, you
know, people who, if your TSH was abnormal and you got thyroid medicine and you feel
great, they don't come see me.
You know, they've self-selected themselves.
The patients I see are the subset.
(17:04):
And I think it's probably as many as 20% of people who either already have hypothyroidism
and they're taking their medicine and it's not working for them, or they never got the
diagnosis in the first place because their TSH was fine.
And what I tend to look at is, first of all, the free hormone levels.
(17:28):
You know, we're real, real reluctant to spend any money on people that's on quote unquote
unnecessary.
Oh my God.
I feel like that's an entirely a whole nother episode.
That's a whole nother.
That's a whole nother podcast episode.
But because lab expense is really quite, I don't want to use the word a scam, but there's
(17:51):
so much wrong with the way we're charged for labs.
Because when I order a complete set of thyroid tests on somebody and they pay me for it,
and then I pay the lab, I pay $55 for that full complete set.
Same, same amount.
Right.
But if they go to try to do that work, they even use it.
(18:12):
It might be $600.
Yeah, exactly.
$600 was what one of my patients got charged when we accidentally thought she had insurance
when she didn't.
So yeah, that's a big thing.
But anyway, so the tests that I order are the free T3 and the free T4, so the free hormone
levels.
I also order the TSH just because I want to know where it's at.
(18:34):
And then I order total T3 and reverse T3.
So there's five tests that I order.
And then if I've never seen a patient before and they're not sure whether they have an
autoimmune disease or not, I will look for autoimmune thyroid disease in people who have
that list of symptoms, that the weight gain, the fatigue, the hair loss, the dry skin,
(18:58):
all the things.
I will order the thyroid globulin, the thyroid peroxidase.
And then if they have low TSH, indicating that they have overactive thyroid function,
I will also order the antibody set that's for Graves' disease, which is the thyroid
stimulating immunoglobulin and the thyroid receptor antibody.
(19:20):
So those are two more that I will order.
If I've never seen a patient before and I don't know why they have thyroid symptoms,
I will generally also order an iodine level just to see because Hashimoto's is probably
90% of hypothyroidism in the US where I practice.
(19:41):
But iodine deficiency is really common too.
And especially in the middle west of the United States, iodine deficiency is extremely common.
And it's actually the reason why iodized salt was invented is so that people wouldn't get
goiters and thyroid disease, which is on a resurgence by the way, because people don't
(20:07):
eat iodized salt anymore.
Exactly.
We've gotten too fancy.
Yes, we have.
Well, I mean, I don't think sea salt is good for you.
I mean, bad for you.
I think sea salt is good for you.
But then you have to realize it doesn't have any iodine in it.
You need to add some iodine.
Yeah.
But anyway, so yeah, those are my five labs.
(20:30):
And the reason I focus on the total T3 and the reverse T3 is this.
And it's a little bit high level, but it's super important to understand this because
reverse T3 and T3 are like yin and yang.
They're a twin pair.
(20:52):
And T3 is the active thyroid hormone that is made in your body cells in order to activate
your cells.
Reverse T3 is something your body makes when it senses that you need to slow down, when
it senses that you might have too much thyroid hormone going on, when it senses that you
(21:13):
might be starving, for example, when your stress levels are extremely high.
Or if you have Hashimoto's disease for some reason, that turns on the making of a lot
of reverse T3.
And reverse T3, if you find it in the literature, most of what it says in literature is that
(21:36):
it's an inactive metabolite, but it isn't.
It is equally as capable of binding to the thyroid receptors in your cells, and it will
block them.
And so if you have a lot of it, even if you have enough T3 in your body, you will not
get the action of it because of the blocking effect of this high reverse T3.
(22:02):
And so I measure reverse T3, and then I compare it with total T3, because then that gives
me a balance, and I know where that ratio is.
And the ratio needs to be about 12 to 1.
It needs to be 12 T3 to 1 reverse T3 molecule for molecule in your blood.
(22:26):
And if it's at that level, then you probably have an adequate balance and an adequate amount
of thyroid hormone in your body.
Now, if you have that, but your TSH is also above 4, then that's also not a good thing.
But if everything else is somewhere within the normal range, and then that ratio is in
(22:50):
that 12 to 1 ratio, then I can honestly say, okay, I have your thyroid balance correctly,
and if you're still having XYZ symptoms, then we need to look for other causes.
Yeah.
Thank you for explaining that.
Yeah.
And it's complicated, and sometimes you have to hear it two or three times, and then you're
(23:13):
like, okay, I'm starting to get it now.
Yeah.
No, I think you explained it well.
I have heard some other explanations that didn't flow.
For lack of a better word.
All right.
Yeah, I try to make it to where it's as easily understandable as possible.
(23:34):
Yeah.
And so, with that in mind, tell us how that then relates clinically to some of these symptoms
folks are seeing in terms of metabolism and those.
Sure.
Yeah.
So, thyroid hormone activates your metabolism.
Thyroid hormone, as it's produced in your thyroid gland, is 90% T4, which is the prohormone
(24:03):
or thyroxin or levothyroxin.
If you take medicine, it's coming in as this prehormone, basically.
It's not active yet.
It has to go out into your body, and 80% of what your cells use is produced right there
at the level of the cells.
And it goes into the cell, it goes to the nucleus, and it activates your genes to start
(24:29):
producing proteins or energy or heat or growing your eyebrows, for example.
That's one of the things.
When people's thyroid balance isn't off, very, very frequently you'll see that they've lost
the corners off of their eyebrows.
(24:51):
And I always ask ladies, did you pluck your eyebrows?
And they're like, no, no, no.
They just fell out.
They're like, OK, I know what's wrong with you.
But your GI tract will do its peristalsis, its contractions, more efficiently.
Your body heat will be generated more efficiently.
Your fat burning is generated more efficiently.
(25:14):
Your energy use.
So I think about it like a car.
So the food that you eat is like the gas that you put in the tank of the car.
But if you don't have the proper balance of thyroid hormone, it's like there's no spark
coming from the spark plugs.
You can't burn the energy properly.
(25:36):
And your body's just like, OK, what are we going to do with this?
Let's just pack it on as fat.
We don't need this right now.
So yeah, it really is responsible for growth.
It's responsible for healing.
It's responsible for optimizing all kinds of other hormonal functions in your body,
(25:58):
like whether or not you're insulin resistant or not, whether or not you have adequate amounts
of sex hormones circulating around, whether your adrenal function is working properly,
whether you have brain function that's working properly.
As a matter of fact, we talked about symptoms.
And one of them that I should have mentioned is ADHD or brain fog or just this scattered
(26:26):
executive function, this scattered way of thinking that you can't quite get if you don't
have enough thyroid hormones.
So that energy production is in your brain as well as in your body.
Right.
Yeah.
I like to think of the thyroid gland.
Really, it's like one of our mastermind glands.
It does so much for our bodies.
(26:49):
And so it is, it's just so important because it does, it has so many functions.
So thank you for touching on those.
Stay tuned to next week's episode of the Essence of Health Tea Time podcast, where there'll
be more of the tea on your thyroid testing, toxins and truth with Dr. Dana Gibbs.
(27:10):
See you then.
Thank you for joining me today on the Essence of Health Tea Time podcast.
Click the subscribe button on your favorite podcast platform so that you never miss a
moment of the Essence of Health Tea Time podcast.
Check out the show notes to obtain your free tips for Healthy Living Guide to get you started
(27:30):
on your health and wellness path.
Follow me on social media at Essence of Health Wellness Clinic on Facebook, Instagram and
YouTube and at doctor.tw at EOHWC on TikTok.
Interested in becoming a member of the Essence of Health coaching program?
(27:50):
Well head on over to www.eohcoaching.com.
The Essence of Health is a You.
Welcome to the Essence of Health Tea Time Podcast.
(00:12):
I am your host, Dr. Shayla Toons-Whithers.
As a double board certified family and obesity medicine physician with over 12 years of experience
in medicine, I teach motivated individuals how to achieve their desired quality of life
while preventing and reversing chronic diseases.
It's tea time!
(00:36):
What part of your health journey is most challenging?
Is it the actual effort of sticking to a plan?
The cooking and the meal planning?
The exercise routine?
Not enough time for everything you think you need to do?
Or the confusion of it all?
If you said yes to any of these obstacles, then keep listening to learn how you can smash
(01:00):
these problems just by checking your email.
You check your email inbox every day already, but what if checking your inbox brought you
better health instead of the stress it sometimes can bring?
Well, I have news for you.
You can improve your health, get a jump start on improving your health conditions, and start
(01:20):
to feel like a better version of you just by checking your email inbox over the next
5 days when you join the free Nourish and Flourish 5 Day Challenge.
You'll get health tips, actionable videos, a goal and habit tracker, and healthy recipes
every day for 5 days.
(01:41):
Better health is the best investment you'll ever make, and this is only a small investment
of your time.
You have nothing to lose, but everything to gain.
The Nourish and Flourish 5 Day Challenge was designed to set the foundation for healthy
habits for life.
Say yes to yourself today and sign up now at drshayla.com forward slash nfchallenge.
(02:06):
I'll also place these details in the show notes.
The essence of health is in you.
See you in your inbox.
On today's episode of the Essence of Health Tea Time podcast, I have a special guest,
Dr. Dana Gibbs.
Dr. Gibbs is a board certified otolaryngologist, thyroid surgeon, and founder of Consultants
(02:28):
in Metabolism, a practice focused on the medical treatment of Hashimoto's disease,
and other complex thyroid-related illnesses and chronic fatigue.
She helps patients who have not responded to levothyroxine or who were not offered treatment
due to normal TSH regain their energy and vitality.
(02:48):
Welcome to the show, Dr. Gibbs.
I'm just ecstatic to have you on the show.
Oh, thank you for having me.
I'm really excited to be here.
This is going to be so much fun.
Yeah, it will be.
So we'll just kick this off with you just telling me, even within your practice, what
are some of those more common thyroid disorders you encounter?
And then what do typically people experience?
(03:10):
Like when they come to you, what kind of things are they experiencing in terms of symptoms?
Okay, sure, absolutely.
So I would say number one most common thing that I see people for is for Hashimoto's disease,
which is an autoimmune condition that attacks your thyroid gland and can cause you to have
(03:33):
either too much thyroid hormone or not enough thyroid hormone circulating in your body at
any given time.
And that fluctuation makes people feel really, really bad.
The other thing that I tend to see people for are other benign thyroid conditions.
Say they have a thyroid nodule that was caused by they don't know what or Graves' disease,
(03:57):
which is a different autoimmune condition, or maybe they've had surgery or they've had
radiation treatment and then they were given medication afterwards to replace their thyroid
hormone and they just don't feel well.
So those are super common things that I see people for.
The common thread running through it for everybody, and not everybody has thyroid problems, but
(04:23):
all my patients have fatigue and sometimes just crushing, debilitating fatigue.
And that tends to be what brings them in.
And they say, okay, I'm giving up on the standard treatment.
I want to try something outside the box.
I'm going to go see this person, which is me.
(04:44):
Yeah, yeah, I can imagine.
So in family medicine, we do tend to see a lot of the fatigue or even weight gain that
folks are commonly presenting with.
And then it's one of those things where if the thyroid does turn out to be perfectly
normal, they're like, oh, I was almost wishing it was my thyroid.
And those are the people that I see and those are the people that I want to see.
(05:08):
Because we have this idea in medicine that this one test, the TSH test is kind of like
the buck stops here.
And if that's fine, then nothing else can be wrong.
And what I've found over the course of years, and it was true for my own health, which is
where I started with it, was that it's not always fine when the TSH is normal.
(05:33):
Yeah.
Tell us a bit more about that.
Okay.
So my personal story was kind of the story of everybody who goes through medical training.
I mean, it's grueling, it's intense, it's long, it just goes on and on and on.
And when I was making the decision to even go to medical school, I was very hesitant
(05:59):
because even starting in about high school, I had started being really tired all the time.
And I didn't know what was wrong with me.
I didn't know that anything was wrong with me.
I just thought, I'm a teenager, I'm tired all the time.
But when I got to college and I got to my senior year of college and it's time to make
(06:19):
that decision, okay, I'm going to go to med school or I'm not going to go to med school,
I'm going to do something else.
I at first chose not to because I thought, I've heard how bad it is.
I don't think I can do it.
I was already that tired.
Yeah, put that in your mind.
Yeah, I mean, it was in my mind that I can't do this.
(06:43):
And then I went out and I tried, I got a job in a science lab and I did that for a while
and I was like, okay, I'm bored.
I'm really meant to be a doctor.
Since I was 10, I wanted to be a surgeon, a heart surgeon or a brain surgeon or something
stupid like that.
I don't know.
But I knew that's what I needed to do all along and I was just dragging my feet and
(07:08):
going, oh, okay, I'm not going to do it.
But then I was like, okay, fine, going to go to med school.
And sure enough, it was, wow, I couldn't have even imagined how hard it was going to be.
It was hard.
And I got on the wards and I got to where I couldn't stay standing up.
(07:30):
I was going to pass out.
I mean, I was having fainting spells on the wards.
I would kneel down in the hall outside a patient's room and take an E and the resident was just
like, well, you're unprofessional, blah, blah, blah.
I was like, Luke, I'm getting ready to pass.
Oh, dude.
(07:51):
And I wasn't assertive enough to defend myself.
I just looked like a lazy whatever in front of all these people.
You're not really allowed to be you're not allowed.
You're not allowed to take time off to show weakness.
You're not allowed to show anything.
But anyway, so I went to the health clinic and I said, hey, I think something's wrong
(08:14):
with me.
I'm nearly passing out on rounds.
What's going on?
And they did some tests and my TSH was fine.
And they said, here, try these antidepressants.
You know, I mean, it's just the thing.
That's what happens.
Right.
And I was like, OK, I'm taking the antidepressants.
They didn't really help.
(08:35):
But maybe that's just who I am.
And I just going to have to use more willpower and try harder, you know, and just put up
with the fact that I'm exhausted all the time.
And I did.
And I went on to residency.
And thank goodness I did E and T and not general surgery because I probably would have died.
(08:56):
You know, I did.
Yeah, I did a year of general surgery and, you know, it was it became close to killing
me.
I don't know.
But the fatigue just kept getting worse and it kept getting worse and kept getting worse.
And I managed to graduate my residency and get out and come home to my mom in my hometown
(09:17):
and get a job here.
And, you know, instead of some going on to some big fancy academic career, because I
was just so tired.
I couldn't think of doing anything else.
And I mean, this is by now almost 20 years of being tired, 20 years.
And I was at a lecture one day, I was at a continuing ed lecture one day, and I had gone
(09:40):
into.
I was there to learn allergy.
That was kind of my thing.
That was that was, you know, E and T and learning allergy because it affects your sinuses and
all that.
And I had heard the lecture before and I was bored.
So I wandered into the next room.
You know how sometimes they have different sessions going on at the same time.
(10:01):
And the lecture was about thyroid.
And the guy put up this slide with all this list of symptoms symptoms.
And by the end of it, my jaw was on the floor.
I was like, holy cow, I have hypothyroidism.
Why didn't anybody ever figure this out?
And of course, they didn't because my TSH was fine.
(10:22):
Nobody dug any deeper.
Nobody dug any deeper.
Nobody knew to dig any deeper.
Most people still don't know.
Right.
But but I went home and I did what that guy said.
And I tried the medicine regimen that he said.
And it was like this miracle.
All of a sudden, I have energy.
All of a sudden, I'm not freezing all the time.
All of a sudden, my hair started to grow back.
(10:44):
My eyebrows started to grow back.
I was like, what is this?
Is this what normal people are like?
Really?
Wow.
You know.
And you know, when I first started on it, I didn't care why it worked.
I didn't care that it made my labs look messed up.
All I cared about was that I felt better.
All I cared about.
(11:04):
But then after I'd been feeling better for a while and I started noticing that same list
of symptoms in my patients, I was like, OK, I can experiment on me, but I can't experiment
on my patients.
I have to know what's going on.
Why does this work?
What's a better way to deal with it?
And so I started looking and eventually found the information that I was looking for.
(11:27):
It's not mainstream, but it is super helpful.
And patient after patient would come in to me and they'd be like, yeah, I've got all
these sinus disease, but I'm also cold and tired and sick and I've had four miscarriages
and blah, blah, blah.
And I'm like, let me see if I can help you.
And I would do what I had learned, which we can talk about.
(11:49):
And people would get better and they would come back and they were like, Doc, I'm pregnant.
I'm going to have a baby.
You know, and I'm wow.
Even just to piggyback off of that, what would you say are some of those most overlooked
symptoms of thyroid dysfunction?
You know, you mentioned with like the fertility issues, but what are those other ones would
(12:10):
you say?
Right.
So, so yeah, first, first is irregular periods and then infertility, repeated miscarriages.
That's a biggie, but there are other symptoms.
There are like, for example, constipation.
I have, I have, um, this is not my patient.
She's a friend of mine who had constipation that was so bad, didn't respond to any other
(12:34):
kinds of treatment, never had an abnormal TSH test.
And I mean, this lady went to the Mayo clinic.
She went to all kinds, you know, all kinds of places.
And then she got pregnant and her GYN gave her thyroid medicine and all of a sudden her
constipation was boom.
It was gone and was like, what?
(12:57):
I mean, she had colon surgery.
Oh my goodness.
Because of this.
I mean, that's how bad it was.
Yeah.
And so, and it was just unrecognized, you know, and, and people think, oh, constipation,
it's a little uncomfortable.
Well, not for her.
It wasn't.
It was, it was life destroy.
(13:17):
It was a life destroying thing for her.
Um, and the surgery that she had that turned out not actually probably to be necessary
is something she can not undo, you know, it's never, um, so that's another one.
And then there are some weird immunological things like people who are sick all the time
who get virus after virus after virus, sinus infection after sinus infection.
(13:42):
Most people it's, you know, and I saw them all the time because I was ENT, I was doing
allergy, I was doing sinus surgery.
They would come in and they'd be like, oh, you know what?
It's six months until I can take time off to have my sinus surgery.
Um, and I'd say, well, you know, Hey, you have these symptoms.
Let's try thyroid treatment for you.
(14:04):
Um, six months later they'd be back and I'd be like, okay, we're ready to schedule your
surgery and it'd be like, oh no, I don't need that.
I'm fine.
I just need more of that thyroid medicine.
It was like, boom, boom.
What is going on here?
This is something real.
Yeah.
So, so that's another big one.
Just the immune issues that go with it.
(14:26):
People don't think about that.
You know, they think about that, you know, we do know that thyroid is an autoimmune,
um, condition.
And so that does make sense too, that you would have other immunological, uh, things
going along with it.
Sure.
And then another that goes kind of along those lines are some weird immune things like vertigo
(14:49):
and chronic urticaria, like hives that come and go and come and go for no apparent reason,
dry itchy skin, hair loss.
You know, I talked to a lot of dermatologists and I'm like, look, I can help your patients
who are losing their hair.
And you know, it's, it's, um, you know, it's not an instantaneous thing, but it's, it's
(15:12):
pretty remarkable when people are like, doc, I have all these little fuzzy hairs growing.
I'm like, I know, I know.
It's really, it's really kind of, um, it's kind of gratifying.
I like it.
Right.
Yeah, I'm sure.
Yeah.
So, so many different symptoms.
If you're frustrated with your weight, taking more medications than you'd like to, have
(15:33):
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(16:19):
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And so you mentioned that a lot of times we tend to just hone in on the TSH and, you know,
don't look any further.
So what types of things should be looked at beyond that TSH?
(16:43):
Sure.
So I always, you know, I mean, the patients that come to me have self-selected for, you
know, people who, if your TSH was abnormal and you got thyroid medicine and you feel
great, they don't come see me.
You know, they've self-selected themselves.
The patients I see are the subset.
(17:04):
And I think it's probably as many as 20% of people who either already have hypothyroidism
and they're taking their medicine and it's not working for them, or they never got the
diagnosis in the first place because their TSH was fine.
And what I tend to look at is, first of all, the free hormone levels.
(17:28):
You know, we're real, real reluctant to spend any money on people that's on quote unquote
unnecessary.
Oh my God.
I feel like that's an entirely a whole nother episode.
That's a whole nother.
That's a whole nother podcast episode.
But because lab expense is really quite, I don't want to use the word a scam, but there's
(17:51):
so much wrong with the way we're charged for labs.
Because when I order a complete set of thyroid tests on somebody and they pay me for it,
and then I pay the lab, I pay $55 for that full complete set.
Same, same amount.
Right.
But if they go to try to do that work, they even use it.
(18:12):
It might be $600.
Yeah, exactly.
$600 was what one of my patients got charged when we accidentally thought she had insurance
when she didn't.
So yeah, that's a big thing.
But anyway, so the tests that I order are the free T3 and the free T4, so the free hormone
levels.
I also order the TSH just because I want to know where it's at.
(18:34):
And then I order total T3 and reverse T3.
So there's five tests that I order.
And then if I've never seen a patient before and they're not sure whether they have an
autoimmune disease or not, I will look for autoimmune thyroid disease in people who have
that list of symptoms, that the weight gain, the fatigue, the hair loss, the dry skin,
(18:58):
all the things.
I will order the thyroid globulin, the thyroid peroxidase.
And then if they have low TSH, indicating that they have overactive thyroid function,
I will also order the antibody set that's for Graves' disease, which is the thyroid
stimulating immunoglobulin and the thyroid receptor antibody.
(19:20):
So those are two more that I will order.
If I've never seen a patient before and I don't know why they have thyroid symptoms,
I will generally also order an iodine level just to see because Hashimoto's is probably
90% of hypothyroidism in the US where I practice.
(19:41):
But iodine deficiency is really common too.
And especially in the middle west of the United States, iodine deficiency is extremely common.
And it's actually the reason why iodized salt was invented is so that people wouldn't get
goiters and thyroid disease, which is on a resurgence by the way, because people don't
(20:07):
eat iodized salt anymore.
Exactly.
We've gotten too fancy.
Yes, we have.
Well, I mean, I don't think sea salt is good for you.
I mean, bad for you.
I think sea salt is good for you.
But then you have to realize it doesn't have any iodine in it.
You need to add some iodine.
Yeah.
But anyway, so yeah, those are my five labs.
(20:30):
And the reason I focus on the total T3 and the reverse T3 is this.
And it's a little bit high level, but it's super important to understand this because
reverse T3 and T3 are like yin and yang.
They're a twin pair.
(20:52):
And T3 is the active thyroid hormone that is made in your body cells in order to activate
your cells.
Reverse T3 is something your body makes when it senses that you need to slow down, when
it senses that you might have too much thyroid hormone going on, when it senses that you
(21:13):
might be starving, for example, when your stress levels are extremely high.
Or if you have Hashimoto's disease for some reason, that turns on the making of a lot
of reverse T3.
And reverse T3, if you find it in the literature, most of what it says in literature is that
(21:36):
it's an inactive metabolite, but it isn't.
It is equally as capable of binding to the thyroid receptors in your cells, and it will
block them.
And so if you have a lot of it, even if you have enough T3 in your body, you will not
get the action of it because of the blocking effect of this high reverse T3.
(22:02):
And so I measure reverse T3, and then I compare it with total T3, because then that gives
me a balance, and I know where that ratio is.
And the ratio needs to be about 12 to 1.
It needs to be 12 T3 to 1 reverse T3 molecule for molecule in your blood.
(22:26):
And if it's at that level, then you probably have an adequate balance and an adequate amount
of thyroid hormone in your body.
Now, if you have that, but your TSH is also above 4, then that's also not a good thing.
But if everything else is somewhere within the normal range, and then that ratio is in
(22:50):
that 12 to 1 ratio, then I can honestly say, okay, I have your thyroid balance correctly,
and if you're still having XYZ symptoms, then we need to look for other causes.
Yeah.
Thank you for explaining that.
Yeah.
And it's complicated, and sometimes you have to hear it two or three times, and then you're
(23:13):
like, okay, I'm starting to get it now.
Yeah.
No, I think you explained it well.
I have heard some other explanations that didn't flow.
For lack of a better word.
All right.
Yeah, I try to make it to where it's as easily understandable as possible.
(23:34):
Yeah.
And so, with that in mind, tell us how that then relates clinically to some of these symptoms
folks are seeing in terms of metabolism and those.
Sure.
Yeah.
So, thyroid hormone activates your metabolism.
Thyroid hormone, as it's produced in your thyroid gland, is 90% T4, which is the prohormone
(24:03):
or thyroxin or levothyroxin.
If you take medicine, it's coming in as this prehormone, basically.
It's not active yet.
It has to go out into your body, and 80% of what your cells use is produced right there
at the level of the cells.
And it goes into the cell, it goes to the nucleus, and it activates your genes to start
(24:29):
producing proteins or energy or heat or growing your eyebrows, for example.
That's one of the things.
When people's thyroid balance isn't off, very, very frequently you'll see that they've lost
the corners off of their eyebrows.
(24:51):
And I always ask ladies, did you pluck your eyebrows?
And they're like, no, no, no.
They just fell out.
They're like, OK, I know what's wrong with you.
But your GI tract will do its peristalsis, its contractions, more efficiently.
Your body heat will be generated more efficiently.
Your fat burning is generated more efficiently.
(25:14):
Your energy use.
So I think about it like a car.
So the food that you eat is like the gas that you put in the tank of the car.
But if you don't have the proper balance of thyroid hormone, it's like there's no spark
coming from the spark plugs.
You can't burn the energy properly.
(25:36):
And your body's just like, OK, what are we going to do with this?
Let's just pack it on as fat.
We don't need this right now.
So yeah, it really is responsible for growth.
It's responsible for healing.
It's responsible for optimizing all kinds of other hormonal functions in your body,
(25:58):
like whether or not you're insulin resistant or not, whether or not you have adequate amounts
of sex hormones circulating around, whether your adrenal function is working properly,
whether you have brain function that's working properly.
As a matter of fact, we talked about symptoms.
And one of them that I should have mentioned is ADHD or brain fog or just this scattered
(26:26):
executive function, this scattered way of thinking that you can't quite get if you don't
have enough thyroid hormones.
So that energy production is in your brain as well as in your body.
Right.
Yeah.
I like to think of the thyroid gland.
Really, it's like one of our mastermind glands.
It does so much for our bodies.
(26:49):
And so it is, it's just so important because it does, it has so many functions.
So thank you for touching on those.
Stay tuned to next week's episode of the Essence of Health Tea Time podcast, where there'll
be more of the tea on your thyroid testing, toxins and truth with Dr. Dana Gibbs.
(27:10):
See you then.
Thank you for joining me today on the Essence of Health Tea Time podcast.
Click the subscribe button on your favorite podcast platform so that you never miss a
moment of the Essence of Health Tea Time podcast.
Check out the show notes to obtain your free tips for Healthy Living Guide to get you started
(27:30):
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(27:50):
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