Look for detox pathways & nutrient deficiencies society. After seeing thousands of patients with thyroid conditions Dr. Olivia Joseph started digging deep into the real root cause of thyroid and hormone imbalances. In this episode, Dr. Bryan and Olivia Joseph begin to unwind the complexity that surrounds the thyroid stigmas and irregular hormones we see today and truly being to show you how you can start taking action steps to get the right testing and help you are seeking!
Table Of Contents
- Introduction to Thyroid Imbalances And Irregular Hormones
- What Is A Thyroid?
- Symptoms Of Having A Thyroid Problem
- Autoimmune Disease: The #1 Cause Of Thyroid Problems
- Eight Hormones To Check for Thyroid Imbalance
- Grab The Thyroid Cheat Sheet
- Irregular Hormones that Mimic Symptoms of Thyroid Dysfunction
- Our Healthcare System is Broken
- Closing Thoughts: Imbalances is NOT a Life Sentence
Introduction to Thyroid Imbalances And Irregular Hormones
Dr. Bryan: Welcome to the Wellness Connection Podcast, giving hope, igniting health and shaping a brighter future. It’s time to get connected.
Dr. Bryan: All right everybody, welcome to the Wellness Connection Show. We are back live Dr. Brian Joseph with my wife Dr. Olivia Joseph.
Dr. Olivia: Hi everyone.
Dr. Bryan: And it is a cold day here in St Louis, so we’re going to try to bring some warmth and some heat to you.
Dr. Olivia: Raise you body temperature by improving thyroid function.
Dr. Bryan: Oh, that’s it. So many people right now are already cold with thyroid problems, so we don’t need to actually, we need to tell you how to help with that. So, today we’re going to dive deep into one of Dr Olivia’s specialties, probably where she’s put the most amount of energy in her clinical experiences, centered around a topic of helping people deal with thyroid dysfunction. So, it’s really, really, really prevalent. But let me start, let me ask you this, what made you get into working with patients with thyroid in the first place?
Working with thyroid cases
Dr. Olivia: My frustration with how frustrated patients were, how sad they were, how they were told it’s age, it’s in their head, it’s irregular hormones when over and over I would see people weren’t getting the right testing. And you know, I work with a lot of physicians, I train doctors, I teach for a nutrition company. And when I would privately have these side conversations with doctors, like why aren’t you doing this testing or why aren’t you evaluating this more, it became blatantly obvious, they weren’t going to dig deep into it. So I really felt like I had to and I remember 15 years I’ve been doing this, I remember 13, 14 years ago thinking, I’m not going to touch thyroid, no way, it’s too complicated.
Dr. Olivia: So I had that thought myself but I really felt like I didn’t have a choice. If I wanted to help my patients, I had to learn.
Dr. Bryan: So I’ve often heard, and you just said it, that working with thyroid cases is relatively complex. So, our intention today is to try to unwind some of the complexity for patients and people that might be hearing this so they can understand that it doesn’t have to be as complex as you may have thought it to be.
Dr. Olivia: It’s not. Doing a puzzle is complex when you’re missing pieces or when you don’t have like the picture that you’re trying to create. That makes it complex. Thyroid is not complex. It’s this perfect harmony but when you’re missing information or you don’t know what things should look like, it becomes very complicated.
What Is A Thyroid?
Dr. Bryan: So let’s start real basic and then work our way up from there. Let’s start with an anatomy lesson. Like what is the thyroid for the people that don’t even know what that is?
Dr. Olivia: Sure. It’s a gland in your neck and it’s shaped like a butterfly and it’s part of your hormone or endocrine system. So, the thyroid gland has a lot to do with energy, metabolism, body temperature. Your thyroid hormones work with your liver, digestive tract, brain, and with your sex hormones.
Dr. Bryan: What is the purpose, I know obviously, and the way the body works, it’s kind of like that old song where the hipbones connected to the knee bone and everything is intertwined and works together. So it’s probably hard to like pull out a singular focus for just what the thyroid may be designed to do. But, if you were to try to define or share with what is the primary purpose or function of the thyroid gland, what would you say it’s designed to do?
Dr. Olivia: You can’t do that in the hormone system. It’s too complex.
Dr. Bryan: But I’m trying to keep this simple.
Thyroid’s most important jobs
Dr. Olivia: What I think one of the thyroid’s most important jobs is to bring oxygen to the cells. Bind oxygen to your cells, which means bring energy. Don’t forget, it’s part of the hormone system. It works with your hypothalamus pituitary on your brain, works with your adrenals from puberty to menopause and women, it’s working with your ovaries. So it’s just part of a hormone system. It’s a piece. You can’t drive a car with one tire or one wheel. You need all four to work together. Think of the thyroid as one of those wheels or tires.
Dr. Bryan: All right, but before we even started recording, you listed some things such as metabolism and some other things in and around that arena. So like what does the thyroid gland get credit for doing in the body frequently? If someone’s thyroid’s not working well, why might we look at the thyroid gland as a problem?
Dr. Olivia: The most common complaint you’re going to hear is fatigue and it’s really like a debilitating fatigue. Thyroid people are very slow starters in the morning, right? They’re just dragging. So that, which obviously makes other things fatigued or lethargic, you see a lot of constipation, hair loss, brain fog. Those are some of the most common complaints you’re going to get. But it affects your metabolism, right? They call it burning fat. You can’t burn fat if you have a low body temperature.
Dr. Bryan: So ultimately it sounds like it’s responsible for slowing things down in your body.
Dr. Olivia: Well said.
Dr. Bryan: All right, so I’m trying to keep it real simple.
Dr. Olivia: I know. You’re good at that.
Symptoms Of Having A Thyroid Problem
Dr. Bryan: So, okay, if it slows things down and, and you’re beginning to have some dysfunction, you referenced this a second ago some of the things that may show up in terms of symptoms, but when you see somebody come in clinically that starts to share their history with you, what do you hear in their history in terms of some symptoms that make like the radars go off in your mind and say this is probably a thyroid problem?
Dr. Olivia: Absolutely. So I hear I’m tired a lot and it’s not always thyroid, right? So it’s not that. Thyroid is so interesting because women and men, it affects women more, innately know something’s not right. They know, like I know something isn’t right, not a matter of, oh, I’m just tired today or I didn’t sleep good last night or I don’t feel good. And the symptoms do show up like chronic constipation, hair loss, cold body temperature.
Dr. Olivia: A red flag for me is these people do not earn their weight, they really don’t. We’re all here, out of the blue, I gained however many pounds and/or no matter how much I exercise, no matter how much I cut my calories, I cannot lose a pound no matter what I do. And I have these women coming in and they give me these food blogs like, look, I’m eating nothing and I can’t lose a pound. And my doctor keeps telling me I need to do more. I need to, or it’s my age or it’s my irregular hormones or it’s in my head. And so those are my red flags.
Infertility related to thyroid imbalance
Dr. Bryan: All right, so I heard you say hair loss fatigue, but the fatigue can come from a number of sources, not just thyroid dysfunction. Constipation or slow bowel movement. Cold intolerance such as like cold hands and cold feet. Earlier you were talking about people have fertility issues because of thyroid dysfunction. So that’s another symptom?
Dr. Olivia: It is. So they say bun in the oven, right? When your TSH is not like between one and two, you’re more likely to have a miscarriage. But when your body temperature is low, implantation is less likely to take place. So the leading cause of infertility today is we don’t know, we don’t know. Healthy anatomy, healthy hormones, we don’t know why implantation isn’t taking place. Well, when you’re trying to get pregnant, you monitor your basal metabolic rate, which is your armpit temperature. What are you looking for? You’re looking for that spike. So implantation can take place. So it does affect fertility as well as miscarriage.
Dr. Bryan: Interesting. I mean, that’s a big issue in society. A lot of people struggling to get pregnant.
Dr. Olivia: And knowing this, I would expect, like when you find out you’re pregnant and you go to the doctor, they do an insane amount of blood work. Insane. And you would just expect like at least a TSH test to be part of that. It’s not, it’s not. You get like 10 vials of blood testing you for STDs, but you don’t look at like basic biologic function that is necessary to sustain a healthy pregnancy.
Autoimmune Disease: The #1 Cause Of Thyroid Problems
Dr. Olivia: Sure. So one thing we know across the board, in our culture, in America is that the rate of autoimmune diseases is going up.
Dr. Bryan: All right, stop there. What’s an autoimmune disease?
Dr. Olivia: An autoimmune disease is when your immune system is so stressed out, it gets confused and it becomes overactive and it starts attacking tissue within the body. So the most common cause of hypothyroidism is Hashimoto’s, which is an autoimmune disease where your own immune system attacks the thyroid. You can have thyroid antibodies attacking your thyroid for decades before your thyroid has enough destruction where it fails. That is the number one cause of thyroid problems is an autoimmune disease attacking your thyroid, creating thyroid symptoms for years before you ever have an abnormal TSH test.
What triggers autoimmune disease?
Dr. Bryan: All right, let’s rewind this a little bit though. Like what triggers the autoimmune disease? Like why do people, like, is this a genetic thing, is this just a lifestyle thing? Like why would people have an autoimmune condition? Digestive issue, like what’s going on?
Dr. Olivia: Both, you just said it, all those three things you just said. First, you have to be genetically programmed for an autoimmune disease. When you’re genetically programmed, you’re not genetically programmed for Hashimoto’s, you’re genetically programmed for autoimmunity. Then something has to trigger it. That could be something in your lifestyle, it could be an infection, it could be something going on in the gut because 70% of your immune system lives in your gut. So I’ve had patients get sick, autoimmune disease turns on. Take antibiotics, autoimmune disease turns on. Something has to trigger it and wake it up. Just because it’s programmed into your genes doesn’t mean that you’re going to get it.
Dr. Olivia: Plus, once you have one autoimmune disease, your risk for others goes up. So, if you have Hashimoto’s, which is the most common autoimmune disease that is in America, not in the world, what you’re going to see is your risk for rheumatoid arthritis is higher, ulcerative colitis, Crohn’s, Celiac, Lupus, all of those things, your risk for those things goes up.
Dr. Bryan: Another doctor shared with me at one point that like leaky gut can contribute to people developing autoimmune conditions, especially thyroid.
Dr. Olivia: Yeah.
We’re not doing enough testing
Dr. Bryan: So it’s interesting and a lot of people have digestive issues in today’s world. So at some point, I’m sure we’ll do a podcast or another episode specifically on digestive issues and gut repair and things that you can do naturally to help yourself. But let’s stay on the thyroid. So here’s something that’s said so frequently and people experience is they’ve been to many, many doctors and they get these tests run and they come back and they say all my labs are normal. I thought I had a thyroid problem but everything’s normal. Can someone still have a thyroid problem after seeing normal test? And then why are so many people getting this report that their test are normal?
Dr. Olivia: Sure. Because they’re not having enough testing.
Dr. Bryan: Speak to that.
Dr. Olivia: They’re not having enough testing. So how you diagnose hypo or hyperthyroidism is TSH, that’s it, thyroid-stimulating hormone. That’s how you get a diagnosis. But that is not how you evaluate thyroid function. Far from it. There are eight thyroid hormones that we check from the get go to properly evaluate what the thyroid is doing and I’d be happy to go through them one by one but we’re going to give everybody a cheat sheet that I created. We’re not doing enough testing, we’re not. We’re doing just enough testing to get a diagnosis, and then you get pills for your diagnosis and you’re on those pills forever, right? You still want to get to the root cause.
Eight Hormones To Check for Thyroid Imbalance
Dr. Bryan: List the eight hormones because typically most patients come in and they actually have like two markers in their thyroid tested and then they’re getting the test results that things are coming back normal but yet they feel so crummy. So when you say they’re not getting tested enough, what are the eight things that you would like to see?
Dr. Olivia: So easy, I categorize them. TSH, you’re going to see virtually everybody have that done. When they have, they test my thyroid doctor or I have fatigue, blah, blah, blah, weight gain. So TSH, T4. Now there’s two T4s. There’s a free and there’s a total. What you need to understand about those irregular hormones is they’re inactive. They don’t make you feel good, they don’t raise your body temperature, they don’t make you burn fat, they don’t get rid of your brain fog.
Dr. Olivia: They do not do anything. But the reason we test those is because those are the first ones you medicate if you get a diagnosis. So when you take a prescription medicine for thyroid, it’s going to be Synthroid or levothyroxine, which is synthetic T4 to get TSH in the normal range. That’s why insurance covers those tests and that’s why those are the most common ones to get tested. Why? Because you get a diagnosis and you take medicine for your diagnosis.
Sexy Hormones & Thyroid antibodies
Dr. Olivia: Now we get to the sexy thyroid hormones. Your active thyroid hormone, which is T3. T3’s job, that’s your fat burning hormone. That hormone brings oxygen to every one of your cells. Just like T4, there’s a free and a total. Your free T3, that’s your active thyroid hormone, that’s the most important one to have in the sweet spot. Then we go to thyroid antibodies. You have to test two. We look at TPO, which is thyroid peroxidase and we look at thyroglobulin or antithyroid globulin. Those should be negative. If they’re present. You have antibodies. What do antibodies do? Attack tissue. What tissue? Your thyroid. Your thyroid is under attack, which is more likely to not only lead to symptoms but destruction in the thyroid.
Reverse T3 & T3 Uptake
Dr. Olivia: And the last two irregular hormones, which I never see tested, which give you information that the thyroid problem isn’t coming from the thyroid, it’s coming from somewhere else., reverse T3. When you see a high Reverse T3, your mind should go to the fact that there could be a cortisol imbalance affecting how well your body absorbs thyroid hormone. So when you see a high Reverse T3, that person is going to be weight loss resistant. The other thyroid hormone is called T3 Uptake. When you see all low T3 Uptake, the first question you asked that person is, are you on hormone replacement therapy or have you been in the past? Almost always they’re on HRT, birth control, bioidentical irregular hormones. So what happens with hormone replacement therapy is it can block or clog the thyroid receptor sites.
Dr. Olivia: So what I just said is, oh my gosh, we could have a conversion problem. Thyroid hormone converts in the liver. We can have an autoimmune disease. Immune cells are in the gut. We could have a cortisol problem, we can have a hormone problem, all leading to dysfunction and imbalance within the thyroid. Those are all on the cheat sheet with what each thyroid hormone does and what the optimal ranges are. So, that’s my gift to you.
Grab The Thyroid Cheat Sheet
Dr. Bryan: That was pretty clinical and actually it’s hard for me to digest and understand that stuff. So I can imagine it’s hard for a lot of people. But clearly there’s a lot more that can be tested than the traditional like two markers is what I was taking out of that and it’s very, very important. And then also you reference this cheat sheet or this gift that you have for people. So, explain what you have that they can take this and boil down in terms of teaching, what is it that you’ve created?
Dr. Olivia: So, those eight thyroid hormones I just went through. Gives you the name of the thyroid hormone, what it’s responsible for, what the optimal ranges are. Because I will tell you, when it comes to thyroid, the normal range varies from lab to lab. If you go to Quest, you go to LabCorp, you go to XYZ Lab, every lab has a different normal range when it comes to thyroid.
Dr. Bryan: So what we’re going to do is we’re going to take her cheat sheet that she tried to simplify this conversation for you so you have a better idea of really the instruction manual on how your thyroid operates and what to look for, and we’re going to make it available on this particular episode’s podcasts. So you can go to the website, thewellnessconnection.com and actually find this particular episode on thyroid and we’ll actually, we’ll put the downloadable cheat sheet for you as a reference so that people can actually get this.
Why you need this cheat sheet
Dr. Olivia: So, I didn’t actually create the cheat sheet for you, for all of you listening. I originally created that cheat sheet for me so I could study and understand and have a cheat sheet to reference as I’m looking at all these labs. Then I use that cheat sheet, it was, this summer I think is two years ago, I was hired to do a thyroid training for physicians because I keep getting, well, I don’t know what this thyroid hormone does or I don’t know what the optimal range is. And I’m like, you need to have this cheat sheet, keep it in your desk when you’re working with patients.
Dr. Olivia: So I actually created it originally for myself then for physicians, and then I thought to myself, everybody needs to have this. Everybody needs to have this optimal range so they know how well their thyroid is functioning and if it’s not, where the problem could be stemming from.
Dr. Bryan: All right, so that gift will be available to you. This is episode 17. So you just look up episode 17 on the website, you’ll be able to find that if you’re looking for it.
Irregular Hormones that Mimic Symptoms of Thyroid Dysfunction
Dr. Bryan: So, let’s get back to this. You shared with me privately that there’s a lot of other irregular hormones in the body that can mimic symptoms of thyroid dysfunction that aren’t necessarily the thyroid that’s the problem. What are some examples of that?
Dr. Olivia: Number one is cortisol. The most common imbalance is a cortisol imbalance. And cortisol affects how you absorb thyroid hormone, but cortisol’s regulating all your sex hormones.
Dr. Bryan: Cortisol is a response to stress, correct?
Dr. Olivia: Yeah, but we all make cortisol. We make more during the day, less at night because it’s not just a response to stress, cortisol is a hormone that gives us energy, helps us deal with stress, but it also keeps our blood sugar stable, our blood pressure stable.
Dr. Bryan: So many people that store belly fat. I remember the commercials years ago for different medications that were coming out trying to help people that were storing belly fat because of too much cortisol in their body. So, that’s interesting. That’s interesting that you share that.
Dr. Olivia: And cortisol is regulated by the adrenal gland.
Dr. Bryan: Are there any other irregular hormones that can mimic thyroid disfunction?
Look for detox pathways & nutrient defficiencies
Dr. Olivia: Yeah. So as I mentioned, when you’re looking at some of those other thyroid hormones, you can see if there’s a conversion problem and thyroid hormone is converted in the liver. If there’s a gut problem with an autoimmune disease and a problem with the immune system, a hormone problem where somebody has taken birth control or hormone replacement therapy that clogged the thyroid receptor sites. So my approach to the thyroid is I don’t just look at those eight thyroid hormones, I look at those eight thyroid hormones and I look at cortisol and I look at sex hormones, estrogen, progesterone, testosterone, DHEA, pregnenolone. I look at all of that.
Dr. Olivia: I look at their detox pathways, I look for nutrient deficiencies because thyroid symptoms look a lot like vitamin D deficiency, iron and ferritin deficiency. So I do all that in one fell swoop. If I see it’s something autoimmune, without a doubt, I want to do a stool analysis because I want to see what’s going on in the gut. We know certain infections within the gut can actually trigger Hashimoto’s such as H. Pylori, which I’ve had the pleasure of having twice. So infections in your gut can turn Hashimoto’s on.
Our Healthcare System is Broken
Dr. Bryan: So, you might be wondering like, why don’t most doctors test in this fashion? Why doesn’t everybody get access to all these different markers? And it’s interesting because being in healthcare for about 15 years, what I’ve identified, it’s sad to say, but our healthcare system is pretty broken in a lot of different ways. But HMOs and PPOs have limited basically the access rights that a lot of patients are able to get in terms of what tests they have access to because they deem these things non-medically necessary oftentimes because you’re going outside of the scope of looking for pathology or disease and you’re trying to really get to the root cause of what’s driving your disease.
Dr. Bryan: Like, a lot of time, an HMO or PPO when you order a blood test might test for only like 20 or 25 markers. Oftentimes, like when we order a test and not just us, when other people that practice functional medicine order a test, we can order a blood test that can look for about 80 markers. It’s night and day. And we’re not restricted in regards to what they’re going to authorize or unauthorize because we get these tests for very inexpensively by bypassing the system.
We don’t have to be stay victimized
Dr. Olivia: Absolutely. The system, it’s more expensive to use the system. And where the system works or what it’s designed for is to diagnose and treat disease. We have a system designed around acute care or sick care. When it comes to things that are chronic, we don’t have a good system. And when you look at thyroid, it is chronic. But they deem so much with the thyroid not medically reasonable or necessary because what you’re doing is you’re going to improve or enhance the quality of life, right? And insurance companies think that’s not our job to improve your quality of life, right? This isn’t going, because thyroid disease really doesn’t affect your life expectancy. It affects your quality of life, not your quantity of life. So, that’s one of the reasons it gets flagged.
Dr. Bryan: So, the good news is, none of us have to really stay in a role of a victim. We don’t have to stay victimized to the system. We can take responsibility and actually we can seek out some of these tests. And some of them are as inexpensive as $20. Some of them are $150 but you can get different things to get a full spectrum of testing to find out if you have any thyroid dysfunction, it’s available to you.
Dr. Olivia: And you can order your own labs. There’s direct to consumer labs and they’re very cost effective.
Autoimmune diseases needs to be treated seriously
Dr. Bryan: Awesome, awesome. Anything else that you want to add regarding, that you want our listeners that might suffer or know someone suffering from thyroid dysfunction to know? I know you had referenced that sometimes there’s iron deficiencies or even vitamin D or like, is there anything else that you want to share before we wrap things up?
Dr. Olivia: I think understand that if you have Hashimoto’s, Hashimoto’s is not a thyroid disease. It’s an autoimmune disease that causes thyroid destruction or can cause thyroid disease. But you have to understand, it’s an autoimmune disease, and once you have one, your risk for others goes up. Autoimmune needs to be treated seriously but also to be managed differently than a thyroid problem. If you have a thyroid problem that’s just a thyroid problem, not an immune problem, you’re very lucky. Like it’s much easier to improve somebody’s quality of life. You get faster results if it’s just this.
You need to combine the right things together
Dr. Olivia: But when you’re looking at the thyroid, you have to look at the thyroid. Have those eight thyroid hormones checked at least initially as a baseline and you’re going to get the best outcome if you’re also looking at cortisol, sex hormones, inflammatory markers and nutrient deficiencies, because the more of the right things we do together, the faster and more permanent the results are. You can’t, like, when you want to lose weight, you can’t say, I’m just going to eat healthy or I’m just going to work out. We know when you combine the right things together, you get better results. It’s logical.
Dr. Olivia: Don’t forget that when you approach the thyroid, the thyroid is one gland within the endocrine system. If you’re not looking at what else the endocrine or hormone system’s doing, you’re missing a lot of information.
Closing Thoughts: Imbalances is NOT a Life Sentence
Dr. Bryan: Well, I guess my closing thoughts would be this, is if somebody does find out that they have some imbalances in these markers, it’s not a life sentence.
Dr. Olivia: No.
Dr. Bryan: And it doesn’t necessarily mean that you have to just treat the symptoms the rest of your life with medication. There are things you can do to get a better grasp on this, to try to reverse it, to try to take control and restore a quality life so that you’re not feeling like your brain’s not firing and they have no energy and that your body doesn’t do what it’s designed to.
Dr. Olivia: I think if your TSH is normal, you’re not going to get a diagnosis and you’re not going to get medication. So the beauty of that, or if you are already diagnosed and medicated, you still want to look at those other factors because they affect how you feel, your metabolism, your quality of life. So, if you have normal TSH, thank the Lord and let’s be preventive and proactive so this destruction does not become permanent to the thyroid. But if you already did get the diagnosis and the medicine, is it the end of the world? It’s not the end of the world. The damage has been done and it is what it is, but let’s look at the other factors that can improve or enhance your quality of life.
Contact us if you need help!
Dr. Bryan: All right. Well, look, if you’re struggling with some of these diaries like symptoms or if you actually know that you have thyroid dysfunction, you’re looking for a way to try to get a better grasp as to how you can get well, contact us anytime, we’d be happy to actually review your lab work that you have or order or some more effective lab work if you don’t have access to it yourself, or point you in the right direction. If it’s not us, we’re always here to help you in any way we possibly can.
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Dr. Bryan: So, really, really appreciate all the solid feedback we keep getting every week from the podcast, the comments have been great, the suggestions of what you want us to talk about have been really, really fun. We do have some fun episodes coming down the pipeline.
Dr. Bryan: As always, we just ask that you do one thing. If you know some person that this may be able to help, someone that possibly may benefit from learning this information, do them a favor, help us on this mission to help more people. Just pass the message, share the link, tell them to go to iTunes and subscribe or go onto Spotify, like we’re on multiple, multiple directories. So you can find the Wellness Connection Show in many, many places. But we want to make sure that we help as many people that are out there that want help. So thank you as always. Until next time, we’re out.
Dr. Olivia: Thank you.
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