Thyroid 101: Everything You Need to Know with Dr. Amie Hornaman
Today on Midlife Conversations, I discuss the importance of understanding thyroid health with my good friend and thyroid expert, Dr. Amie Hornaman, also known as the Thyroid Fixer. Dr. Amy shares her personal journey with hypothyroidism and Hashimoto’s and highlights the common issues with traditional thyroid testing. We dive into what thyroid markers to look for, such as T3, T4, TSH, and reverse T3, and the importance of being an educated patient. We also explore the nuances of thyroid medication, including the use of T3, and the interconnectedness of thyroid health with cholesterol and insulin levels. This episode is a comprehensive Thyroid 101 guide to help you advocate for your own health and seek proper diagnosis and treatment.
Thyroid was always something I knew could be an important factor, but I didn’t really dive deep until the numbers became a red flag on MY own personal labs in midlife. In this episode we are going to do a basic thyroid 101 for us ALL. The more we can understand, the better we are equipped to be our health advocate and know what to ask and talk to our doctors about!
SO MANY PEOPLE just get told “you’re normal, everything is fine” or “eat less and exercise more!” but that’s really NOT the answer more often than not (especially when you’re doing all of the right things already!). The same thing happened to Dr. Amie. It wasn’t until she was seven doctors deep that she FINALLY got a diagnosis of hypothyroidism and Hashimotos. She was given T4. But five months later, nothing had improved. She went on a deep dive and found that T4 is inactive, it can push up reverse T3 and put you into survival mode, it doesn’t convert well, and it really was solving NOTHING.
So, let’s break it down in this Thyroid 101!
What Labs Are the BEST Labs for Thyroid?
Conventional doctors in western medicine will likely only check your TSH and your Free T4. However, those don’t paint a great picture. To get a CLEAR picture of our thyroid health, we should be looking at Free T4, Reverse T3, Free T3, and AntiTPO and AntiTG antibodies.
TSH: thyroid stimulating hormone. TSH, however, is NOT a thyroid hormone; it’s a pituitary hormone that talks to your thyroid. If your body doesn’t have enough thyroid, your body will pump out TSH to tell your thyroid to get to work. When your TSH is high, your thyroid is in a hypothyroid state. If your thyroid were optimally producing thyroid hormones, your TSH wouldn’t be elevated. Optimal numbers for TSH is less than 2, but your standard western doctors will tell you it can go up to 4.5. When doctors ONLY test TSH, they are missing a huge piece of the puzzle to your health and symptoms.
Free T4: T4 is the inactive thyroid hormone, and the FREE means how much is in your system waiting to be delivered and converted into T3, which is the form your entire body can use. To be converted into T3, it must first lose an iodine molecule. You cannot chase optimal T4.
Reverse T3: Anti-thyroid hormone. Like the bouncer at the club keeping you from getting inside the doors. If we are fighting for our lives, we WANT the Reverse T3 to be elevated so we can survive. However, if we are walking around with elevated reverse T3, we are walking around in constant survival mode. The ONLY thing that can convert to and drive up the reverse T3 is the T4 thyroid hormone. OPTIMAL Reverse T3 we want less than 12 and the standard conventional range can go up to a 24 or 25.
Free T3: T3 is the active thyroid hormone! FREE means how much of it is unbound, in your blood, ready to get to the cell to work its magic and turn on your body processes – like metabolism, and growing hair, etc. Conventional medicine and labs can place you between a 2.2-4.4, but OPTIMAL would be in the upper quadrant of that – so 3.8 or above in this example. It’s okay if this one is a little elevated above the standard range, as long as you’re feeling good.
Anti TPO & Anti TG: These are thyroid antibodies that allow us to test for the autoimmune condition of hypothyroid. Is your body attacking your own thyroid gland? We want BOTH of these numbers to be at 0. Think of these as soldiers fighting your good guys. If your number is 13, you have 13 soldiers fighting your own thyroid! Conventional medicine will wait until you hit 34 soldiers fighting you before they diagnose you!
Thyroid Medications and Thyroid Hormone Replacement
When you are taking thyroid medications, you are replacing your thyroid hormones. It’s replacing a hormone that your body is NOT producing. The key is to get PROPER thyroid replacement.
The thyroid is very nuanced and honestly requires a thyroid expert because everyone needs to be treated differently based on their own unique bodies.
A LOT of times your doctors will tell you start taking T4…and this is actually NOT accurate in all cases. If your body is not properly converting T4 into T3 free, and instead creating elevated REVERSE T3, you wouldn’t give it MORE T4. Instead, you would be better off if you started off on T3 only. This is one example of how it is SO important to have someone who knows your specific full picture before prescribing.
The KEY here is that there are many combinations of thyroid hormones that will work for YOUR specific case. Your doctor needs to tailor your dose to you and your specific needs.
How Do I Approach This With My Doctor As An Educated Patient?
- Ask for the tests outlined above: TSH, Free T4, Reverse T3, Free T3, Anti TPO, and Anti TG. Spell them out, be specific. You cannot just say “please test my thyroid”.
- Have a bulleted list of symptoms you are experiencing
- Have these optimal labs values on hand for you to reference
- Then explain based on the optimal numbers, and your symptoms, you’re concerned the T4 will continue to push up the REVERSE T3, and instead it sounds like you need T3 (just using my personal scenario as an example)
Is There A Connection Between Thyroid and Cholesterol?
YES. In fact there is a thyroid, insulin, cholesterol triangle. The thyroid will dysregulate your lipid panel (cholesterol). The thyroid also controls your glucose control/blood sugar response and the amount of insulin your pancreas secretes. So, if your thyroid is off, 99% of the time, we see insulin resistance. In turn, the biggest driver of cholesterol is insulin/high glucose.
We NEED cholesterol – it’s the building block for our hormones. However, there are problems in interpreting cholesterol.
- Total cholesterol standard western labs have been reduced to around 200 and your western doctors get MASSIVE kickbacks to prescribe you a statin. Statins are NOT the answer. They have sooo many awful side effects.
- What is your entire lipid panel? If your good markers are great and your bad markers are not bad, then total cholesterol is of no concern really.
- You can reduce your cholesterol TOO low!
- You’ve GOT to get to the bottom of what is creating the picture for your cholesterol numbers.
This and more on this episode!
About Dr. Amie Hornaman
Dr. Amie Hornaman “The Thyroid-Fixer”, is host to the top-rated podcast in medicine and alternative health: The Thyroid Fixer™, with listeners around the globe. She is the founder of The Institute for Thyroid and Hormone Optimization, an organization with transformational, proven approaches to address thyroid dysfunction and support people in returning to full health.
Dr. Amie is also the creator of The Fixxr™ Supplement line with revolutionary, proprietary supplements that are changing the lives of many people. Ultimately, she is a woman on a mission to optimize thyroid patients around the world and give them their lives back.
After her own experience of insufferable symptoms, misdiagnoses and improper treatment, Dr. Amie set out to help others who she KNEW were going through the same set of frustrations and who were on the same medical roller coaster.
She grabs your hand, gives you answers about your health that no one has told you and gives you the actual tools and personalized treatment to fix you. What makes her program unique is the extra support and accessibility that you can’t find anywhere else. That’s the transformational journey. With a focus on optimizing thyroid and hormone function, and thus optimizing her patients, Dr. Amie looks at you as a unique individual and not JUST a lab value. She examines all factors that tie into thyroid dysfunction and thyroid symptoms and FIXES you to give you your life back.
Learn more about Dr. Amie Hornaman at:
Dr. Amie Hornaman on IG: www.instagram.com/dramiehornaman
Dr. Amie Hornaman Website: www.dramiehornaman.com
Dr. Amie Hornaman’s Free Facebook Group: https://www.facebook.com/groups/dramie
Dr. Amie’s Podcast https://dramiehornaman.com/pages/podcasts
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