September 23, 2025 • 23 mins
In this episode, Dr. Alfred Alessi goes into the connection between thyroid function and weight management. They discuss the thyroid gland's role in the HPT axis and how dysfunction affects weight. A case study underscores the risks of misdiagnosis and the need for thorough testing. Common symptoms are highlighted as vital warning signs. Sponsored by Alessi Functional Health's six R gut healing protocol, the episode stresses comprehensive testing in functional medicine. Practical tips for eliminating thyroid triggers and lifestyle changes are shared. Personalized assistance from Alessi Functional Health is available, encouraging listener engagement.
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Episode Transcript
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(00:00):
Patients asking questions around weight loss,stubborn weight loss, inflammation, why they
(00:04):
feel like they've tried everything and theycan't get the weight to go down.
And the thyroid can often be the missed pieceof that puzzle.
But if your t three is low or reverse t threeis high, your body is literally fighting
against fat loss.
Welcome to Health Decode, your number onesource for real health information with your
(00:25):
host, doctor Alessi and Matt Tack.
Welcome back to another episode of HealthDecoded.
I am your host, doctor Alessi.
And today's episode is going to be focusedaround what we are calling the hidden thyroid
weight connection.
Now, is a topic that I really have been lookingforward to digging into for a while, and
(00:47):
something that's been a little bit moreprevalent as of late.
Patients ask asking questions around weightloss, stubborn weight loss, inflammation, why
they feel like they've tried everything andthey can't get the weight to go down.
And the thyroid can often be the missed pieceof that puzzle.
And so we're going to take this into a foursegment part episode that way you know what to
(01:10):
expect.
Segment one is we're going to talk about whythe thyroid controls your metabolism, what the
thyroid is, how it works.
Segment two, we're going to get into what aresome symptoms or red flags of thyroid and
weight dysfunction.
Then we're going to talk about how we test thethyroid in functional medicine, not just with
basic testing, but comprehensive labs.
(01:31):
And then we're going to pull it all togetherand talk about how do we fix the thyroid and
weight connection in functional medicine.
And so, thank you for joining me today.
If you've been listening to the show for awhile, you know that we're just here to decode
the myths around health, provide value to ourlisteners and help educate and impact those to
go spread the word to others.
(01:52):
So if you've enjoyed the show, please share,please follow so you can stay informed and then
share this with someone that you know couldbenefit from the information.
So let's at least let's get started here.
Okay?
So if you're not familiar with what it is, yourthyroid is a small butterfly shaped gland that
sits right in the front of your neck.
And it's small, but it's the master regulatorof your metabolism.
(02:16):
And in functional medicine, we call it thethermostat.
It basically controls how your body burnscalories, how much energy you're gonna produce,
how warm or cold you might feel and even howsharp your brain is.
It even controls the rhythm at which your heartbeats.
And so every single cell in your body hasthyroid hormone receptors.
And so when the thyroid is off, a lot of thingsdownstream can be affected.
(02:41):
And so the way the thyroid works, right?
And we've touched on this briefly in pastepisodes, particularly in like the gut and
hormone episodes, but your thyroid does notwork in isolation.
It's part of what we call an axis, particularlythe HPT axis, which is your hypothalamus, your
pituitary gland and your thyroid gland.
And there's basically a chain in which theytalk to each other.
(03:03):
And so the way it works, your brain's pituitarygland, which is inside your skull, sends
signals, which is thyroid stimulating hormone.
It sends that signal like a boss givinginstructions to the thyroid.
What happens then is your thyroid is going toproduce T4, which is the inactive storage form
of thyroid hormone.
(03:25):
Then, T3, which is the active form, the bodyneeds to convert to that, correct, right?
So the one that actually enters the cells andtells them to crank up metabolism is your T3.
This is your, the fat burning hormone, right?
Now, reverse T3, think of this as the emergencybreak.
So, if your body is stressed, inflamed, or youhave a lot of toxicity, it can convert T4 into
(03:48):
reverse T3 to try to slow things down.
So, your body's trying to always maintain alevel of balance.
Now, most T3 is actually made outside thethyroid in your gut and your liver.
And so, when people have poor digestion, whenthey have things like SIBO, leaky gut, inflamed
gut, toxic overload, This can actually go backupstream that axis and affect the thyroid and
(04:12):
cause dysfunction.
And so, you know, when the thyroid slows downeven a little bit, weight loss actually becomes
kind of like that uphill battle.
You could be eating clean, exercising, doingall the right things.
But if your T three is low or reverse T threeis high, your body is literally fighting
against fat loss.
We always talk about how our approach to fatloss in functional medicine is very much
(04:36):
focused on becoming healthy first.
Your body is not going to prioritize losing fator burning fat when there's inflammation and
there's dysfunction.
It's going to prioritize the fires first.
And so, there was a study in the Journal ofClinical Endocrinology and Metabolism 2019 that
said even subtle thyroid dysfunction, which ishigh to normal TSH or low T3 is linked with
(05:00):
higher body fat and metabolic slowdown.
There's also another study out of Lancet in2020 that said individuals with TSH in the
normal but upper range had significantly higherrates of insulin resistance and weight gain
compared to those in the lower to normal range.
Now, the reason that's important is becausestandard conventional medicine is going to read
(05:21):
a lab within reference range as normal, tellyou you're fine, go about your day.
They wait until something goes dramaticallywrong for them to take action.
In functional medicine, we narrow the referencerange to be optimal, not just normal.
And so, a lot of you know, conventional docs,they're only testing the TSH.
They're looking for TSH and maybe T3 or T4.
(05:44):
They're not checking reverse T3.
They're not checking the antibodies that couldbe causing the thyroid to be, you know, your
body to be attacking its own thyroid tissue.
And so, that's where we must take a deeperlook.
And so, I want to use an example what we calllike a patient case example.
And I'm not going to use any names butbasically had a patient, she was 38 years old.
(06:07):
She was working out often honestly like five,six days a week, maybe more than she needed to
be.
And she was eating what we would consider aclean diet, but she was very exhausted,
fatigued.
She had things like thinning hair and shecouldn't lose weight no matter what she was
trying.
And so, all these signs, obviously, first thingI was thinking was hormones, thyroid, let's
(06:29):
investigate.
She had gone to her family doctor who told herher labs were fine.
She brought the labs to me.
All they had run was which was at like a 3.9which they you know, still considered normal
but is on the higher range.
And then we ran a full panel and we saw that T3was low, reverse T3 was high and she had
(06:52):
antibodies for what we would call Hashimoto'swhich is an autoimmune thyroid disease.
And so once we address this, we did some moretesting and we actually addressed her gut.
And we found leaky gut syndrome.
And so, when the gut is inflamed and damaged,it can cause what's called leaky gut or
basically intestinal permeability.
(07:13):
The gut is starting to break down.
And so, we had to not just go straight for thethyroid because you know, standard medicine is
going to put medication in you on to focus onthe thyroid.
We had to go to the gut first, right?
What was the root cause?
So we worked on balancing the gut, fixing thegut issue, then supporting the thyroid on the
back end.
The symptoms went away, obviously that wasactually the first thing that happened.
(07:36):
But then upon retesting, we found that thepanel got better and the TSH was back down at
normal range, optimal range I would say.
And the antibodies weren't gone but they werestarting to go down as well.
And so then now for her, was just a matter ofsupporting that and maintaining that lifestyle
that we had incorporated.
So, that's just an example of what can happen,right?
(07:58):
And why functional medicine takes a deeper lookand why we focus on things like that.
Now, let's get into the next piece here wherewe can talk about like what symptoms or red
flags you can expect or should be looking forwith thyroid weight dysfunction, we call it.
And so, some of the common hypothyroidsymptoms, hypo meaning slow or low thyroid, are
(08:19):
things like weight gain, especially likestubborn belly fat, even when you're eating
clean and working out.
Cold intolerance, if you're always needing asweater when other people are comfortable.
Chronic fatigue, you wake up tired even withenough sleep.
You're fatigued throughout the day and you justcan't catch up on sleep.
(08:39):
Brain fog, very common is to have like thatslow thinking, poor memory, difficulty
concentrating, poor recovery from exercise,thinning hair, dry skin and brittle nails,
right?
Basically like collagen kind of symptoms.
Constipation and bloating.
So definitely gut issues are very common with alow thyroid.
(08:59):
And then in females, irregular or heavymenstrual cycles more than normal or off of the
actual standard cycle.
And now the opposite of that is what we callhyperthyroid.
Hyper meaning fast or elevated, right?
So on the flip side, it's kind of the oppositeof all those symptoms, right?
Unexplained weight loss despite eating enough.
(09:22):
Anxiety, nervousness, people getting likepalpitations, that jittery feeling.
Insomnia, right?
Maybe feeling wired at night, unable to sleep,sweating excessively, heat intolerance, and
then frequent bowel movements or diarrhea.
These are again, very much the opposite of thehypothyroid.
So, there's two different ranges here.
(09:43):
And now, let's dig into kind of what you couldexperience with what we call like the hidden
culprit, which is Hashimoto's.
And I've shared my story many times on here,but this was what I was dealing with.
I had a hidden Hashimoto's even with normalthyroid, right?
And so I was, my body was attacking its ownthyroid tissue.
Was just a matter of time that I possibly wouldgo low thyroid, but I was able to get ahead of
(10:06):
it.
And so Hashimoto's actually accounts for ninetypercent of hypothyroid cases.
But it doesn't show up overnight.
It takes time for this to build with very vagueor even like subtle symptoms that people won't
notice.
And it can swing between the hyper and thehypothyroid.
People can feel wired for bits of time and thenexhausted for bits of time.
(10:27):
And they're just very much fluctuating on thisspectrum.
And by the time it gets diagnosed, honestly,usually much of the thyroid tissue has already
been damaged.
And so, in a journal of autoimmunity reviews2019, autoimmune thyroid disease often precedes
diagnosis by years with nonspecific symptomslike fatigue, mood swings, weight fluctuation
(10:49):
dismissed as stress, aging or just you're beinga mom, right?
We hear that all the time.
Oh, you have kids.
This is just normal to be feel like this.
And so, the subclinical hypothyroidism is oftenlinked to increased abdominal fat and insulin
resistance even before full blown diseasedeveloped.
So, these are just things to be aware of,right?
(11:11):
We always say symptoms are not normal.
Symptoms are your check engine light.
Everybody has a car, right?
We drive our car, check engine light comes on,you need to figure out why it's going on.
That's what your symptoms, your pains, thesedysfunctions are.
And so, now that we know what the thyroid is,why it matters when it comes to metabolism and
(11:31):
weight, we know kind of what to look for, whatred flags.
Let's talk about how we test this to make surewe're in the right playing field.
But first, let's take a quick word from one ofour sponsors.
Hey, Health Decoded listeners.
I'd like to share a story with you.
There was this man who on the outside lookedhealthy, like he had everything going right.
(11:53):
He was fit.
He worked out.
He ate clean.
But beneath the surface, even unknown to him,his body was breaking down until one day he
crashed.
Full blown fatigue, burnout, he couldn't eventhink or make it through the day without a nap.
After finally turning to functional medicineblood work and discovering he had an autoimmune
(12:16):
thyroid condition caused by leaky gut, he wasable to take action and restore his health.
Well, guess what?
That person was me.
And that's what led me to tirelessly worktoward creating an option for people who wanted
a way out.
The result was my six R gut healing protocol.
Backed by advanced functional testing, thissystem uncovers the root of dysfunction and
(12:41):
uses a step by step formula proven to restore,rebalance, and completely heal the gut.
We only open this program to a select number ofpatients each month.
So if you're ready to finally take control ofyour gut health, visit
alessifunctionalhealth.com/gut and take thequiz to see if you qualify for this program.
(13:06):
I look forward to seeing you soon.
Alright.
Welcome back.
Now, let's talk testing because this is wheremost people are curious, most people want to
take action, and where most people getcompletely missed or dismissed by their
conventional doc.
And so, the reality is that most conventionaldoctors, as I said before, I'm gonna beat this
dead horse, they only test TSH and maybe T4.
(13:30):
That's like checking the gas gauge in your carwithout ever looking under the hood, right?
It gives you a sliver of the picture, but itleaves patients walking away with a you're
fine, things are normal diagnosis when theyclearly don't feel fine.
So, our full thyroid testing approach lookslike this.
At Alessi Functional Health, we're going to digdeeper.
So, a true thyroid assessment includes TSH,free T4, which is the storage hormone, free T3,
(13:59):
which is the active hormone, reverse T3, whichis the basically the metabolic brake pedal.
We're going to check thyroid antibodies, TPOand TG to screen for Hashimoto's or
autoimmunity.
And we're going to check total T3 or T3 uptake,which is a deeper look at how your body is
transporting those hormones.
And so, that's not enough still.
(14:20):
For functional medicine, we want to testfurther.
We want to look into the gut because the gut isoften associated with these dysfunctions
upstream.
And so we can do gut testing.
We have a really awesome test called the deepgut scan.
It's going to test for zonulin, calprotectin,stool panel that's going to basically look into
the system, the ecosystem of the gut.
(14:41):
Is the bacteria within balance?
Is their leaky gut syndrome?
Is there IBD or IBS?
We also want to test for micronutrients.
So looking at things like selenium and zincbecause these are very important for building
the thyroid.
These are basically the raw materials yourthyroid needs to function.
We also test the adrenals with a salivary testbecause stress and thyroid are basically two
(15:04):
sides of the same coin.
And as always, we like to test for toxins.
Testing for heavy metals, BPAs, pesticides,mold can basically tell us if there's any kind
of like endocrine disruption being had fromthese types of toxins.
And so, you know, some of the red flags that wecatch that others could miss, Things like a
(15:25):
normal TSH that's at the higher range, but thenfree T3 is at the bottom, but it was never
tested, right?
Or prime example, young mom with low ferritinpositive antibodies, but she was dismissed as
postpartum fatigue because they didn't lookdeep enough into the testing.
And so she had the symptoms, but there was notenough testing done to create a diagnosis,
(15:49):
which you know, would be early Hashimoto's inthis situation.
And so there's a cool study out of Frontiers inEndocrinology 2021 that confirmed that thyroid
antibody positivity can precede clinicalhypothyroidism by five to ten years.
So oftentimes people have the thyroidantibodies building, but the actual thyroid
(16:11):
hormones are not being affected yet.
And so without full testing, these patients aretold they're fine while under the surface, the
immune system is actually silently attackingtheir thyroid.
Again, this is my story.
And so, you know, if you're only testing theTSH, you're practicing 1980s medicine.
That's what I'd say.
Because functional medicine in the age that welive in, we have the ability to test all the
(16:35):
things that matter.
We have the ability to be proactive andpreventative, and not just waiting for things
to fall apart.
And so, you know, speaking of that, let's talkabout how we can now transition from taking the
data from testing and actually fix the problem,right?
Not just cover it up, not just manage symptoms,but fix the actual dysfunction.
(16:57):
And so, this is where things get exciting.
This is usually where people are like, Oh, Iwant to hear this part, right?
I want to know what to do.
And so there's an appropriate way to do it.
And so, you don't just slap a medication on it,call it a day because then you aren't really
creating any conditions for the thyroid toactually recover, you're just covering it up.
And so, functional medicine is root cause.
(17:18):
When we say that it means we're getting to theroot of the problem, right?
And so, oftentimes inflammation is not even theroot.
It's something causing the inflammation thatthen is causing the dysfunction.
And so, have to really dig deep with ourquestioning, with our testing, and then come up
with solutions.
And so step one is always, always, alwaysremove the triggers.
Like what foods could be triggering thedysfunction in the gut or in the thyroid?
(17:41):
Is it gluten, dairy, processed sugars that areleading to inflammation?
So gluten in particular is a known trigger forautoimmune disease.
Environmental plastics, things like BPAs,pesticides, heavy metals, endocrine disruptors
that block thyroid hormone conversion.
And so there was a study actually,Environmental Health Perspectives 2016 found
(18:04):
that BPA exposure was significantly associatedwith altered thyroid hormone levels in women.
And so, here's a practical tip.
We're always fans of that, right?
Is swap your plastic water bottles forstainless steel or even glass.
And then going organic when it comes to thefoods that are on that dirty dozen list that we
(18:24):
talked about.
These can make a big impact of not continuingto put the things in the body that are causing
the issue, right?
Step two, heal the gut, right?
So step one was remove the triggers.
Step two is going to be heal the gut.
If 70 to 80% of your immune system is in yourgut, then that's right where autoimmunity
starts.
And so, we use specific tools, specific tests.
(18:47):
We actually have a protocol that's six monthsto take you from you could be completely
wrecked to all the way completely healed.
Your gut is functioning perfect and normal Andthen obviously from there, we target the actual
things like the thyroid that need attention.
And so, then from there, step three, right?
What I just spoke to is support nutrition,right?
(19:09):
And so, we use specific nutrients for thyroidthings like selenium, which reduces antibodies,
helps convert the T4 to T3.
Iodine, you know, obviously within a specificamount, we don't want to do too much.
Zinc and B12 are very important because theseare critical coenzymes for hormone production
(19:30):
and energy.
And then vitamin D is responsible for immuneregulation and metabolism as well.
And then step four, balance the hormones andthe stress.
And so we can use certain things likeadaptogens, but also prioritizing lifestyle,
sleep, exercise, movement, all these things arelifestyle medicine practices to help to avoid
(19:52):
flare ups.
And then step five is using advanced tools,right?
We can dig in and get deep with things likepeptide therapy.
Peptides like thymosin alpha-one or BPC-one 157can actually modulate immunity and repair
tissue.
We can work on benefiting the mitochondriasupporting the mitochondria and then targeted
(20:13):
nutraceuticals.
We also have access to really cool thingscalled bio regulators.
I do a course of bio regulators maybe once aquarter or every other you know, every four to
five months to give my body the raw buildingblocks it needs to build back up tissue.
And so in particular to the thi the thymolineone.
And so, you know, sometimes medication isnecessary.
(20:36):
I always like to say we're not like antimedicine, we're just pro doing something that
makes sense.
And so, sometimes medication is necessary, youneed to take a course of it, but it's not going
to be the fix.
And so, can use it for a bit to get you backmaybe stable, but getting to the root cause is
always going to be the long term plan becausethat's where we'll actually correct the
(20:58):
problem.
And so one last, little quote here, theAmerican Journal of Lifestyle Medicine 2021
concluded, and this is huge, that lifestyle anddietary interventions remain the foundation of
thyroid health, even in autoimmune thyroiditis.
Basically translate that you can't out medicatelifestyle.
(21:18):
Take all the medicine you want.
If you don't change your lifestyle, if youdon't change your habits, nothing's going to go
away.
You're going to be stuck in this cycle.
And so really final takeaway, thyroiddysfunction isn't a weight loss death sentence.
But if you don't fix the thyroid, no diet orworkout plan is going to get you there.
And so you need to start from the root, right?
(21:38):
Is it the gut?
Is it the thyroid?
Is it the hormones?
Find out where the problem is, correct that,and then your body will want to prioritize
losing weight.
And so this is why in our total care program,we don't just take a glance, we map out
everything.
We're going to guide you along the entireprocess.
And so, if you would like to learn more abouthow we help diagnose, reverse and heal thyroid
(22:00):
dysfunction and weight loss through ourfunctional medicine programs, go to
alessifunctionalhealth.com, Schedule aconsultation with me or one of my other
providers and let's create a personalized planfor you.
Listeners of the podcast, you're always goingto get exclusive discounts and price reductions
on all of our protocols, lab testing and followups and stuff like that.
(22:22):
So be sure to mention where you heard about us.
As always, I do ask you if you found value inthis episode, please like, subscribe to the
show and then share this with someone who needsto hear it.
That's how we grow the message and that's howwe change more lives, the impact piece.
Also, you want to get in touch with us or befeatured on an episode, share your story, email
us your questions at askalessiefxhealth dotcom.
(22:46):
You can also visit alessifunctionalhealth.com,sign up for the newsletter, check out our
resources, and learn more about our approach tonutrition and cutting edge therapies.
Thanks again for tuning into Health Decoded.
I'm Doctor.
Alessi, and I'll see you on the next one.
Thank you for tuning in to Health Decoded,where we break down the truth about all things
(23:07):
health and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
someone who needs to hear this.
For more w resources and personalized support,visit us alessifunctionalhealth.com and sign up
for our newsletter.
To hear your questions answered live on theshow, send them to askalessifxhealth dot com.
(23:31):
That's askalessifxhealth dot com.
Until next time, stay curious, stay empowered,and remember your health is in your hands.
Patients asking questions around weight loss,stubborn weight loss, inflammation, why they
(00:04):
feel like they've tried everything and theycan't get the weight to go down.
And the thyroid can often be the missed pieceof that puzzle.
But if your t three is low or reverse t threeis high, your body is literally fighting
against fat loss.
Welcome to Health Decode, your number onesource for real health information with your
(00:25):
host, doctor Alessi and Matt Tack.
Welcome back to another episode of HealthDecoded.
I am your host, doctor Alessi.
And today's episode is going to be focusedaround what we are calling the hidden thyroid
weight connection.
Now, is a topic that I really have been lookingforward to digging into for a while, and
(00:47):
something that's been a little bit moreprevalent as of late.
Patients ask asking questions around weightloss, stubborn weight loss, inflammation, why
they feel like they've tried everything andthey can't get the weight to go down.
And the thyroid can often be the missed pieceof that puzzle.
And so we're going to take this into a foursegment part episode that way you know what to
(01:10):
expect.
Segment one is we're going to talk about whythe thyroid controls your metabolism, what the
thyroid is, how it works.
Segment two, we're going to get into what aresome symptoms or red flags of thyroid and
weight dysfunction.
Then we're going to talk about how we test thethyroid in functional medicine, not just with
basic testing, but comprehensive labs.
(01:31):
And then we're going to pull it all togetherand talk about how do we fix the thyroid and
weight connection in functional medicine.
And so, thank you for joining me today.
If you've been listening to the show for awhile, you know that we're just here to decode
the myths around health, provide value to ourlisteners and help educate and impact those to
go spread the word to others.
(01:52):
So if you've enjoyed the show, please share,please follow so you can stay informed and then
share this with someone that you know couldbenefit from the information.
So let's at least let's get started here.
Okay?
So if you're not familiar with what it is, yourthyroid is a small butterfly shaped gland that
sits right in the front of your neck.
And it's small, but it's the master regulatorof your metabolism.
(02:16):
And in functional medicine, we call it thethermostat.
It basically controls how your body burnscalories, how much energy you're gonna produce,
how warm or cold you might feel and even howsharp your brain is.
It even controls the rhythm at which your heartbeats.
And so every single cell in your body hasthyroid hormone receptors.
And so when the thyroid is off, a lot of thingsdownstream can be affected.
(02:41):
And so the way the thyroid works, right?
And we've touched on this briefly in pastepisodes, particularly in like the gut and
hormone episodes, but your thyroid does notwork in isolation.
It's part of what we call an axis, particularlythe HPT axis, which is your hypothalamus, your
pituitary gland and your thyroid gland.
And there's basically a chain in which theytalk to each other.
(03:03):
And so the way it works, your brain's pituitarygland, which is inside your skull, sends
signals, which is thyroid stimulating hormone.
It sends that signal like a boss givinginstructions to the thyroid.
What happens then is your thyroid is going toproduce T4, which is the inactive storage form
of thyroid hormone.
(03:25):
Then, T3, which is the active form, the bodyneeds to convert to that, correct, right?
So the one that actually enters the cells andtells them to crank up metabolism is your T3.
This is your, the fat burning hormone, right?
Now, reverse T3, think of this as the emergencybreak.
So, if your body is stressed, inflamed, or youhave a lot of toxicity, it can convert T4 into
(03:48):
reverse T3 to try to slow things down.
So, your body's trying to always maintain alevel of balance.
Now, most T3 is actually made outside thethyroid in your gut and your liver.
And so, when people have poor digestion, whenthey have things like SIBO, leaky gut, inflamed
gut, toxic overload, This can actually go backupstream that axis and affect the thyroid and
(04:12):
cause dysfunction.
And so, you know, when the thyroid slows downeven a little bit, weight loss actually becomes
kind of like that uphill battle.
You could be eating clean, exercising, doingall the right things.
But if your T three is low or reverse T threeis high, your body is literally fighting
against fat loss.
We always talk about how our approach to fatloss in functional medicine is very much
(04:36):
focused on becoming healthy first.
Your body is not going to prioritize losing fator burning fat when there's inflammation and
there's dysfunction.
It's going to prioritize the fires first.
And so, there was a study in the Journal ofClinical Endocrinology and Metabolism 2019 that
said even subtle thyroid dysfunction, which ishigh to normal TSH or low T3 is linked with
(05:00):
higher body fat and metabolic slowdown.
There's also another study out of Lancet in2020 that said individuals with TSH in the
normal but upper range had significantly higherrates of insulin resistance and weight gain
compared to those in the lower to normal range.
Now, the reason that's important is becausestandard conventional medicine is going to read
(05:21):
a lab within reference range as normal, tellyou you're fine, go about your day.
They wait until something goes dramaticallywrong for them to take action.
In functional medicine, we narrow the referencerange to be optimal, not just normal.
And so, a lot of you know, conventional docs,they're only testing the TSH.
They're looking for TSH and maybe T3 or T4.
(05:44):
They're not checking reverse T3.
They're not checking the antibodies that couldbe causing the thyroid to be, you know, your
body to be attacking its own thyroid tissue.
And so, that's where we must take a deeperlook.
And so, I want to use an example what we calllike a patient case example.
And I'm not going to use any names butbasically had a patient, she was 38 years old.
(06:07):
She was working out often honestly like five,six days a week, maybe more than she needed to
be.
And she was eating what we would consider aclean diet, but she was very exhausted,
fatigued.
She had things like thinning hair and shecouldn't lose weight no matter what she was
trying.
And so, all these signs, obviously, first thingI was thinking was hormones, thyroid, let's
(06:29):
investigate.
She had gone to her family doctor who told herher labs were fine.
She brought the labs to me.
All they had run was which was at like a 3.9which they you know, still considered normal
but is on the higher range.
And then we ran a full panel and we saw that T3was low, reverse T3 was high and she had
(06:52):
antibodies for what we would call Hashimoto'swhich is an autoimmune thyroid disease.
And so once we address this, we did some moretesting and we actually addressed her gut.
And we found leaky gut syndrome.
And so, when the gut is inflamed and damaged,it can cause what's called leaky gut or
basically intestinal permeability.
(07:13):
The gut is starting to break down.
And so, we had to not just go straight for thethyroid because you know, standard medicine is
going to put medication in you on to focus onthe thyroid.
We had to go to the gut first, right?
What was the root cause?
So we worked on balancing the gut, fixing thegut issue, then supporting the thyroid on the
back end.
The symptoms went away, obviously that wasactually the first thing that happened.
(07:36):
But then upon retesting, we found that thepanel got better and the TSH was back down at
normal range, optimal range I would say.
And the antibodies weren't gone but they werestarting to go down as well.
And so then now for her, was just a matter ofsupporting that and maintaining that lifestyle
that we had incorporated.
So, that's just an example of what can happen,right?
(07:58):
And why functional medicine takes a deeper lookand why we focus on things like that.
Now, let's get into the next piece here wherewe can talk about like what symptoms or red
flags you can expect or should be looking forwith thyroid weight dysfunction, we call it.
And so, some of the common hypothyroidsymptoms, hypo meaning slow or low thyroid, are
(08:19):
things like weight gain, especially likestubborn belly fat, even when you're eating
clean and working out.
Cold intolerance, if you're always needing asweater when other people are comfortable.
Chronic fatigue, you wake up tired even withenough sleep.
You're fatigued throughout the day and you justcan't catch up on sleep.
(08:39):
Brain fog, very common is to have like thatslow thinking, poor memory, difficulty
concentrating, poor recovery from exercise,thinning hair, dry skin and brittle nails,
right?
Basically like collagen kind of symptoms.
Constipation and bloating.
So definitely gut issues are very common with alow thyroid.
(08:59):
And then in females, irregular or heavymenstrual cycles more than normal or off of the
actual standard cycle.
And now the opposite of that is what we callhyperthyroid.
Hyper meaning fast or elevated, right?
So on the flip side, it's kind of the oppositeof all those symptoms, right?
Unexplained weight loss despite eating enough.
(09:22):
Anxiety, nervousness, people getting likepalpitations, that jittery feeling.
Insomnia, right?
Maybe feeling wired at night, unable to sleep,sweating excessively, heat intolerance, and
then frequent bowel movements or diarrhea.
These are again, very much the opposite of thehypothyroid.
So, there's two different ranges here.
(09:43):
And now, let's dig into kind of what you couldexperience with what we call like the hidden
culprit, which is Hashimoto's.
And I've shared my story many times on here,but this was what I was dealing with.
I had a hidden Hashimoto's even with normalthyroid, right?
And so I was, my body was attacking its ownthyroid tissue.
Was just a matter of time that I possibly wouldgo low thyroid, but I was able to get ahead of
(10:06):
it.
And so Hashimoto's actually accounts for ninetypercent of hypothyroid cases.
But it doesn't show up overnight.
It takes time for this to build with very vagueor even like subtle symptoms that people won't
notice.
And it can swing between the hyper and thehypothyroid.
People can feel wired for bits of time and thenexhausted for bits of time.
(10:27):
And they're just very much fluctuating on thisspectrum.
And by the time it gets diagnosed, honestly,usually much of the thyroid tissue has already
been damaged.
And so, in a journal of autoimmunity reviews2019, autoimmune thyroid disease often precedes
diagnosis by years with nonspecific symptomslike fatigue, mood swings, weight fluctuation
(10:49):
dismissed as stress, aging or just you're beinga mom, right?
We hear that all the time.
Oh, you have kids.
This is just normal to be feel like this.
And so, the subclinical hypothyroidism is oftenlinked to increased abdominal fat and insulin
resistance even before full blown diseasedeveloped.
So, these are just things to be aware of,right?
(11:11):
We always say symptoms are not normal.
Symptoms are your check engine light.
Everybody has a car, right?
We drive our car, check engine light comes on,you need to figure out why it's going on.
That's what your symptoms, your pains, thesedysfunctions are.
And so, now that we know what the thyroid is,why it matters when it comes to metabolism and
(11:31):
weight, we know kind of what to look for, whatred flags.
Let's talk about how we test this to make surewe're in the right playing field.
But first, let's take a quick word from one ofour sponsors.
Hey, Health Decoded listeners.
I'd like to share a story with you.
There was this man who on the outside lookedhealthy, like he had everything going right.
(11:53):
He was fit.
He worked out.
He ate clean.
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crashed.
Full blown fatigue, burnout, he couldn't eventhink or make it through the day without a nap.
After finally turning to functional medicineblood work and discovering he had an autoimmune
(12:16):
thyroid condition caused by leaky gut, he wasable to take action and restore his health.
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I look forward to seeing you soon.
Alright.
Welcome back.
Now, let's talk testing because this is wheremost people are curious, most people want to
take action, and where most people getcompletely missed or dismissed by their
conventional doc.
And so, the reality is that most conventionaldoctors, as I said before, I'm gonna beat this
dead horse, they only test TSH and maybe T4.
(13:30):
That's like checking the gas gauge in your carwithout ever looking under the hood, right?
It gives you a sliver of the picture, but itleaves patients walking away with a you're
fine, things are normal diagnosis when theyclearly don't feel fine.
So, our full thyroid testing approach lookslike this.
At Alessi Functional Health, we're going to digdeeper.
So, a true thyroid assessment includes TSH,free T4, which is the storage hormone, free T3,
(13:59):
which is the active hormone, reverse T3, whichis the basically the metabolic brake pedal.
We're going to check thyroid antibodies, TPOand TG to screen for Hashimoto's or
autoimmunity.
And we're going to check total T3 or T3 uptake,which is a deeper look at how your body is
transporting those hormones.
And so, that's not enough still.
(14:20):
For functional medicine, we want to testfurther.
We want to look into the gut because the gut isoften associated with these dysfunctions
upstream.
And so we can do gut testing.
We have a really awesome test called the deepgut scan.
It's going to test for zonulin, calprotectin,stool panel that's going to basically look into
the system, the ecosystem of the gut.
(14:41):
Is the bacteria within balance?
Is their leaky gut syndrome?
Is there IBD or IBS?
We also want to test for micronutrients.
So looking at things like selenium and zincbecause these are very important for building
the thyroid.
These are basically the raw materials yourthyroid needs to function.
We also test the adrenals with a salivary testbecause stress and thyroid are basically two
(15:04):
sides of the same coin.
And as always, we like to test for toxins.
Testing for heavy metals, BPAs, pesticides,mold can basically tell us if there's any kind
of like endocrine disruption being had fromthese types of toxins.
And so, you know, some of the red flags that wecatch that others could miss, Things like a
(15:25):
normal TSH that's at the higher range, but thenfree T3 is at the bottom, but it was never
tested, right?
Or prime example, young mom with low ferritinpositive antibodies, but she was dismissed as
postpartum fatigue because they didn't lookdeep enough into the testing.
And so she had the symptoms, but there was notenough testing done to create a diagnosis,
(15:49):
which you know, would be early Hashimoto's inthis situation.
And so there's a cool study out of Frontiers inEndocrinology 2021 that confirmed that thyroid
antibody positivity can precede clinicalhypothyroidism by five to ten years.
So oftentimes people have the thyroidantibodies building, but the actual thyroid
(16:11):
hormones are not being affected yet.
And so without full testing, these patients aretold they're fine while under the surface, the
immune system is actually silently attackingtheir thyroid.
Again, this is my story.
And so, you know, if you're only testing theTSH, you're practicing 1980s medicine.
That's what I'd say.
Because functional medicine in the age that welive in, we have the ability to test all the
(16:35):
things that matter.
We have the ability to be proactive andpreventative, and not just waiting for things
to fall apart.
And so, you know, speaking of that, let's talkabout how we can now transition from taking the
data from testing and actually fix the problem,right?
Not just cover it up, not just manage symptoms,but fix the actual dysfunction.
(16:57):
And so, this is where things get exciting.
This is usually where people are like, Oh, Iwant to hear this part, right?
I want to know what to do.
And so there's an appropriate way to do it.
And so, you don't just slap a medication on it,call it a day because then you aren't really
creating any conditions for the thyroid toactually recover, you're just covering it up.
And so, functional medicine is root cause.
(17:18):
When we say that it means we're getting to theroot of the problem, right?
And so, oftentimes inflammation is not even theroot.
It's something causing the inflammation thatthen is causing the dysfunction.
And so, have to really dig deep with ourquestioning, with our testing, and then come up
with solutions.
And so step one is always, always, alwaysremove the triggers.
Like what foods could be triggering thedysfunction in the gut or in the thyroid?
(17:41):
Is it gluten, dairy, processed sugars that areleading to inflammation?
So gluten in particular is a known trigger forautoimmune disease.
Environmental plastics, things like BPAs,pesticides, heavy metals, endocrine disruptors
that block thyroid hormone conversion.
And so there was a study actually,Environmental Health Perspectives 2016 found
(18:04):
that BPA exposure was significantly associatedwith altered thyroid hormone levels in women.
And so, here's a practical tip.
We're always fans of that, right?
Is swap your plastic water bottles forstainless steel or even glass.
And then going organic when it comes to thefoods that are on that dirty dozen list that we
(18:24):
talked about.
These can make a big impact of not continuingto put the things in the body that are causing
the issue, right?
Step two, heal the gut, right?
So step one was remove the triggers.
Step two is going to be heal the gut.
If 70 to 80% of your immune system is in yourgut, then that's right where autoimmunity
starts.
And so, we use specific tools, specific tests.
(18:47):
We actually have a protocol that's six monthsto take you from you could be completely
wrecked to all the way completely healed.
Your gut is functioning perfect and normal Andthen obviously from there, we target the actual
things like the thyroid that need attention.
And so, then from there, step three, right?
What I just spoke to is support nutrition,right?
(19:09):
And so, we use specific nutrients for thyroidthings like selenium, which reduces antibodies,
helps convert the T4 to T3.
Iodine, you know, obviously within a specificamount, we don't want to do too much.
Zinc and B12 are very important because theseare critical coenzymes for hormone production
(19:30):
and energy.
And then vitamin D is responsible for immuneregulation and metabolism as well.
And then step four, balance the hormones andthe stress.
And so we can use certain things likeadaptogens, but also prioritizing lifestyle,
sleep, exercise, movement, all these things arelifestyle medicine practices to help to avoid
(19:52):
flare ups.
And then step five is using advanced tools,right?
We can dig in and get deep with things likepeptide therapy.
Peptides like thymosin alpha-one or BPC-one 157can actually modulate immunity and repair
tissue.
We can work on benefiting the mitochondriasupporting the mitochondria and then targeted
(20:13):
nutraceuticals.
We also have access to really cool thingscalled bio regulators.
I do a course of bio regulators maybe once aquarter or every other you know, every four to
five months to give my body the raw buildingblocks it needs to build back up tissue.
And so in particular to the thi the thymolineone.
And so, you know, sometimes medication isnecessary.
(20:36):
I always like to say we're not like antimedicine, we're just pro doing something that
makes sense.
And so, sometimes medication is necessary, youneed to take a course of it, but it's not going
to be the fix.
And so, can use it for a bit to get you backmaybe stable, but getting to the root cause is
always going to be the long term plan becausethat's where we'll actually correct the
(20:58):
problem.
And so one last, little quote here, theAmerican Journal of Lifestyle Medicine 2021
concluded, and this is huge, that lifestyle anddietary interventions remain the foundation of
thyroid health, even in autoimmune thyroiditis.
Basically translate that you can't out medicatelifestyle.
(21:18):
Take all the medicine you want.
If you don't change your lifestyle, if youdon't change your habits, nothing's going to go
away.
You're going to be stuck in this cycle.
And so really final takeaway, thyroiddysfunction isn't a weight loss death sentence.
But if you don't fix the thyroid, no diet orworkout plan is going to get you there.
And so you need to start from the root, right?
(21:38):
Is it the gut?
Is it the thyroid?
Is it the hormones?
Find out where the problem is, correct that,and then your body will want to prioritize
losing weight.
And so this is why in our total care program,we don't just take a glance, we map out
everything.
We're going to guide you along the entireprocess.
And so, if you would like to learn more abouthow we help diagnose, reverse and heal thyroid
(22:00):
dysfunction and weight loss through ourfunctional medicine programs, go to
alessifunctionalhealth.com, Schedule aconsultation with me or one of my other
providers and let's create a personalized planfor you.
Listeners of the podcast, you're always goingto get exclusive discounts and price reductions
on all of our protocols, lab testing and followups and stuff like that.
(22:22):
So be sure to mention where you heard about us.
As always, I do ask you if you found value inthis episode, please like, subscribe to the
show and then share this with someone who needsto hear it.
That's how we grow the message and that's howwe change more lives, the impact piece.
Also, you want to get in touch with us or befeatured on an episode, share your story, email
us your questions at askalessiefxhealth dotcom.
(22:46):
You can also visit alessifunctionalhealth.com,sign up for the newsletter, check out our
resources, and learn more about our approach tonutrition and cutting edge therapies.
Thanks again for tuning into Health Decoded.
I'm Doctor.
Alessi, and I'll see you on the next one.
Thank you for tuning in to Health Decoded,where we break down the truth about all things
(23:07):
health and empower you to take charge of yourwell-being.
If you found value in today's episode, pleasesubscribe, leave a review, and share it with
someone who needs to hear this.
For more w resources and personalized support,visit us alessifunctionalhealth.com and sign up
for our newsletter.
To hear your questions answered live on theshow, send them to askalessifxhealth dot com.
(23:31):
That's askalessifxhealth dot com.
Until next time, stay curious, stay empowered,and remember your health is in your hands.
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