Dr. Jockers Functional Nutrition

Heal Your Thyroid and Reboot Your Metabolism in 30 Days with Dr Justin Marchegiani.

37 min
Feb 17, 20263 months ago
Listen to Episode
Summary

Dr. Justin Marchegiani discusses thyroid health and metabolism optimization, explaining how thyroid hormones control energy production and the critical role of liver and gut function in thyroid hormone conversion. The episode covers root causes of hypothyroidism including insulin resistance, stress, nutrient deficiencies, and autoimmune factors, with practical dietary and lifestyle interventions for a 30-day thyroid reboot.

Insights
  • Thyroid issues are rarely isolated—they require addressing gut health, liver function, nutrient density, and stress management simultaneously rather than treating thyroid hormones in isolation
  • Conventional medicine's reliance on TSH testing misses early-stage autoimmune thyroid disease; functional medicine practitioners should test TPO and thyroid antibodies to catch seronegative autoimmunity
  • T4-to-T3 conversion depends on multiple cofactors (selenium, zinc, magnesium, iron) and liver/gut health; insulin resistance and chronic stress directly impair this conversion process
  • Blood sugar stability is foundational to thyroid health—insulin resistance and poor glucose control suppress thyroid hormone production and increase metabolic dysfunction
  • Sleep deprivation and chronic stress mobilize 25-30 grams of glucose via cortisol-driven gluconeogenesis, mimicking a Snickers bar's worth of sugar and disrupting thyroid-dependent metabolism
Trends
Functional medicine practitioners increasingly recognize autoimmune thyroid disease as systemic dysfunction requiring multi-system intervention rather than hormone replacement aloneGrowing consumer awareness of microplastics and environmental toxins (glyphosate, heavy metals, mold) as thyroid disruptors driving demand for detoxification-focused health protocolsRising adoption of continuous glucose monitoring and blood sugar testing by health-conscious consumers to personalize nutrition and identify insulin resistance before clinical diagnosisShift toward desiccated thyroid glandulars and bioidentical hormone protocols over synthetic T4-only treatments, reflecting functional medicine's preference for whole-food-derived therapeuticsIncreased focus on estrogen metabolism and gut dysbiosis as root causes of thyroid dysfunction in women, particularly related to birth control pill use and beta-glucuronidase imbalanceExpansion of nutrient-dense, grain-free, and autoimmune-protocol diets as foundational thyroid health interventions, moving away from vegan/vegetarian approaches lacking fat-soluble vitaminsGrowing recognition of HPA axis dysfunction and dopamine depletion as upstream drivers of thyroid hormone signaling failure, not just pituitary or thyroid gland pathology
Topics
Thyroid hormone physiology: TSH, T4, T3, reverse T3, and deiodinase enzyme functionAutoimmune thyroid disease: Hashimoto's vs. Graves', TPO antibodies, thyroid-stimulating immunoglobulinsT4-to-T3 conversion: liver function, selenium, zinc, magnesium, iron, and gut dysbiosisInsulin resistance and blood sugar stability as thyroid dysfunction root causesHPA axis dysfunction: cortisol, dopamine, TRH, and hypothalamic-pituitary-thyroid signalingGut dysbiosis and beta-glucuronidase: estrogen reabsorption and thyroid hormone metabolismFat-soluble vitamin deficiencies: vitamin A, D, E, K in thyroid receptor functionSleep deprivation effects on growth hormone, cortisol, and glucose mobilizationEnvironmental toxins: glyphosate, heavy metals, mold, microplastics, and thyroid disruptionEstrogen dominance and progesterone deficiency in women with thyroid dysfunctionNutrient density vs. calorie counting in thyroid health optimizationIntermittent fasting protocols for insulin resistance with thyroid considerationsPost-meal blood glucose testing: 1-hour, 2-hour, and 3-hour targets for metabolic healthDesiccated thyroid glandulars vs. synthetic levothyroxine: pro-hormones and calcitonin benefitsFunctional medicine testing: organic acids, MTHFR variants, comprehensive thyroid panels
Companies
Paleo Valley
Sponsor providing grass-fed meat sticks marketed as blood sugar-stabilizing, nutrient-dense snacks without additives ...
Purity Health
Sponsor offering anagaine-infused hair growth formula targeting hair follicle reactivation with liposomal delivery te...
Chef's Foundry
Sponsor providing P600 ceramic non-stick cookware marketed as microplastic-free alternative to Teflon-coated pans
People
Dr. Justin Marchegiani
Functional medicine practitioner and author of 'The Thyroid Reboot'; discusses thyroid physiology, autoimmunity, and ...
Dr. David Jockers
Podcast host and functional nutrition expert; conducts interview and provides clinical context on thyroid-gut-liver c...
Dr. Josh Axe
Referenced as podcast host of 'The Doctor Josh Axe Show' covering hormones, gut health, and functional medicine pract...
Quotes
"If you have a thyroid issue, most likely you've got a liver and gut issue going on. You've got to address the liver and the gut in order to make sure the thyroid is functioning well."
Dr. David JockersMid-episode
"If you're stressed and you make a bunch of cortisol because of that touch of spots, you're literally mobilizing via gluconeogenesis, a snickers bar worth of sugar—25 to 30 grams of sugar or glucose gets stimulated with an acute stress response."
Dr. Justin MarchegianiLate episode
"Every cell has a receptor site for thyroid hormones. It controls energy, controls body temperature. Essentially, anytime you have a down-regulation in energy or metabolic activity in a certain area, you get fatigue, mood issues, bowel motility, difficulty adapting to stress."
Dr. Justin MarchegianiEarly-mid episode
"Conventional medicine really ignores that underlying mechanism. They're just giving you some synthetic T4 with a sodium molecule bound to it and that's there to bring that TSH down because if T4 is low downstream, if we can increase the T4, then that TSH seesaw is back down."
Dr. Justin MarchegianiMid-episode
"You can't just treat the thyroid in isolation. That's why we're doing all of the functional medicine principles first. That's the foundation and then we come here."
Dr. Justin MarchegianiLate-mid episode
Full Transcript
They've done studies not even on college kids where they did sleep deprivation and after one week, the kids were pre-diabetic. So, sleep helps a lot with blood sugar stability because you're less healing, you're less recovered because you made less growth hormone. You're going to have more cortisol and more cortisol mobilizes sugar. If you're stressed and you make a bunch of cortisol because of that touch spots, you're literally mobilizing via gluconeogenesis, a snickers bar worth of sugar. This podcast is sponsored by our friends over at Paleo Valley and if you have not tried at their grass-fed meat sticks, what are you waiting for? These meat sticks are amazing. If you go out and you look for beef jerky or something like that, even if you can find it grass-fed, it's always loaded with sugar, additives, preservatives. That's why I'm so excited about grass-fed meat sticks from Paleo Valley. They are an amazing snack. They can even be a meal replacement. There's no sugar, additives or preservatives in them. They're kid-friendly, high in protein and healthy fats that stabilize your blood sugar, helps you get rid of cravings, support muscle development, it helps you burn fat. They taste amazing. They're from grass-fed cows, so they have the proper omega-6 to 3 fatty acid ratio, which helps bring down inflammation. They're loaded with powerful animal-based nutrients that support your immune function, your energy and your skin health. My kids love these. They're kid-friendly. My children snack on these on a regular basis. I really enjoy them. We keep a lot on stock. They're kind of our emergency food or a quick grab if we need something in a hurry. I love the grass-fed meat sticks from Paleo Valley. They've got some great flavors. They've got not only beef, but also turkey if you don't eat red meat. I think the beef tastes the best. I love the original. They've got a summer sausage, garlic summer sausage. They've got a number of different flavors that are amazing. A teriyaki, that's really good as well. Check them out. Go to PaleoValley.com-forewardslash-jokers. That will actually give you 15% off your order. You can check out other Paleo Valley products as well. Go to PaleoValley.com-forewardslash-jokers. Check out the grass-fed meat sticks as well as their other great products today. Here with my good friend, Dr. Justin, Mark Adjani, he just wrote a new great book, The Thyroid Reboot, How to Identify and Address Your Top 10 Symptoms in 30 Days. Dr. Justin is a wealth of knowledge when it comes to natural health. I'm excited about this interview. Justin, how are you doing today? Dr. Juckers, it is great to be here. Excited to chat with you. It's always a fun time when we get together. Appreciate it. Yeah, absolutely. We go way back. We've been talking for what? Seven years. Seven years. That's right. That's right. We're putting out content for many years, 10, 15 years. Awesome about your book, The Thyroid Reboot. Excited to dive into that. Let's start with just talking about the importance of the thyroid. How do thyroid hormones impact our physiology? Well, thyroid hormones control metabolism. Metabolism is the sum of all chemical reactions in the body. Every cell has a receptor site for thyroid hormones. It controls energy, controls body temperature. Essentially, anytime you have a down-regulation in energy or metabolic activity in a certain area, fatigue, mood issues, bowel motility, difficulty adapting to stress, and then of course, the more stress you are, that can impact sympathetic nervous system and parasympathetic. Then you're not recovering as much. You're more stressed. You're making less stomach acid and enzymes and less bile. You're not absorbing your food. Then you're making it easier for bugs and microbes to overgrow. Of course, 80% of you are immune system is in the gut. As the gut starts to go, so does the immune system. We know most thyroid issues have an autoimmune component to it. That means your immune system is attacking the thyroid tissue. Conventional medicine really ignores that underlying mechanism. Yeah, absolutely. When we talk about thyroid issues, most of the time people deal with hypothyroidism or too low thyroid hormone circulating. Some people can also deal with hyperthyroidism. Can you go through common symptoms that somebody is dealing with one of these thyroid issues? Yes. Most thyroid issues in regards to hyperthyroid are going to be things like graves. Only about 1% or less of thyroid issues are on the hyper on the autoimmune graveside. Typically, what you're going to see is you have TSH, which is your pituitary hormone. It's a brain hormone. Most doctors are actually testing, they're saying, we're testing for your thyroid. They're really actually testing a brain hormone that talks to your thyroid. When TSH, it's an inverse. As TSH goes up, it's because your thyroid is not listening and making thyroid hormones. It's kind of like as a parent, right? You have to raise your voice if your kids aren't listening. Your thyroid is raising its voice to get the thyroid to make T4, which is more inactive and then T4 gets converted to T3, which is more active. As TSH drops, it's usually an indirect correlation or an indirect correlation that the thyroid's higher. With graves, for instance, we see very low TSH, below 0.5 or lower. That usually is indicative of higher T4 and then higher T3. You're going to have things like irritability, anxiety, sweating, insomnia, heart palpitations or abnormal heart rate heart rhythm. Of course, if it goes to extreme, you can have a thyroid storm where the hormones so high, it could potentially create a stroke or a heart issue. It's on the more rare side, but you're going to see a hallmark there. These things called TSI, thyroid stimulating immunoglobulins, and TRAB, thyroid receptor site antibodies that bind to the outside of the thyroid. They just whip it like a tired horse and it just makes it go really high. You can see that. Again, a lot of times, Hashi Modos, though, can feel like graves in early stages because you have these other antibodies called TPO or thyroid globulin antibodies that come in. They attack the thyroid and you can have a little bit of this leakage of thyroid hormone that comes out that can feel acutely like graves. Sometimes people that have the Hashi Modos hypothyroid and again, it always starts off a little bit hyper, but then over time it will go hypow, but it can still feel like it's hyper with true graves, but also with true Hashi Modos too. So Hashi Modos is autoimmune hypothyroidism where the body is attacking the thyroid, damaging a thyroid tissue and over time. Again that leads to inadequate production of thyroid hormone. Hashi Modos is the number one root cause of clinical hypothyroidism. Correct. And a lot of times, Hashi Modos, it takes years to go hypow, takes a very, very long period of time. So it's not going to happen that way out of the gate. And again, conventional medicine, if you're just relying on TSH, you could potentially have this underlying mechanism happening for over a decade before anything is done. That's the hard part. Yeah, for sure. It's late stage indicators. Like if you have to wait to your house is like on fire and smoking, well, the fire detector should pick up the smoke as soon as it happens, right? So we want a early stage indicator and conventional medicine, you know, their treatment for autoimmune issues like, let's say it's joint issues or gut issues are going to be biologics like Humera or Emberl or they're going to do like, you know, different, you know, suppressants or maybe extreme steroids. And they just shut down the immune system. They shut down the inflammation or if they use prednisone, it's going to create potential bone issues or high blood sugar issues, not going to fix the problem, the underlying issue. And those medications inherently have a lot of side effects. So when it comes to conventional medicine, they typically don't prescribe those drugs for autoimmune thyroid issues. And so you're left with really nothing to treat the autoimmunity. They're just giving you some synthetic T4 with a sodium molecule bound to it to their called scintoroid or levoxyl or level thyroxin. And that's there to bring that TSH down because if T4 is low down stream, if we can increase the T4, then that TSH seesaw is back down. It's a seesaw. So if T4 is low and TSH is high and you bring up a T4, it should see saw back down the TSH. That's kind of what they're treating. Yeah, I want to circle back to that and help people understand TSH T4, T3 and how thyroid hormone actually gets to the cell. But first, what are the most common symptoms somebody's dealing with hypothyroidism? So you can have some of these hyperthyroid symptoms too. So you could have anxiety. You could have insomnia. Tail tail ones are going to be especially more for women. You're going to see the hair shedding, the hair thinning, the outer third of the eyebrow. You're going to potentially have cold hands, cold feet, especially if it's a normal 70, mid to low 70 day. And someone shakes your hand. You can really feel that cold hand or you can see rain odds phenomenon where you have the vasospasms and your fingers get really, really white when it's colder out. Those are all tail tail signs. You can even see bowel motility issues and constipation. Those are pretty common too. And so it's, and these things kind of overlap with the adrenal. People think, well, oh, also fatigue. So yeah, I have fatigue. I have some mood issues. I may have some dysregulation in regards to how I deal with stress. I may have some sleep. These can kind of overlap with adrenal problems. That's kind of the hard thing about it. So like the hallmark I really look at is going to be the cold hands, the cold feet, the hair thinning, those tend to stand alone more with thyroid. Yeah. Yeah, for sure. And that outer third of the eyebrow, I don't think the eyebrow thinning. Yeah. Correct. It's one of the big things people can look at. Right. Constipation would be another big thing. Yeah, bowel motility. Yeah. Correct. But again, you could have bowel motility problems because you have adrenal issues. True. You have SIBO. So that's why I always tell patients if we're on the fence. So and also lower body temperatures are big one. So we can do a basal metabolic temperature test. And so with low thyroid, you tend to see lower basal temperature, let's say in the lower 97s, chronically low, where adrenal issues, the temperature tends to be lower, but it also bounces around. So if we have steady low, that tends to be more thyroid. If we have low but bouncing around low, that could be more adrenal and thyroid. If we have normal but bouncing around, that could be more adrenal. And again, these aren't like set 100% things. These are just, it's a clinical tool that we'll look at and say, hey, why don't you test this and let's see. But in the end, we're going to order the right testing to confirm either way. Yeah, for sure. Just want to take a moment to interrupt this podcast to tell you about one of my favorite podcasts I listened to. It's called The Doctor Josh Axe. Show hosted by my good friend, Dr. Josh Axe. Every week he shares how to balance your hormones, restore your gut, boost your energy and slow aging without relying on harsh medications or quick fixes. He shares both ancient biblical practices and the latest breakthroughs in nutrition, herbal remedies and lifestyle medicine. And he sits down with world renowned experts to have real unfiltered conversations. You won't hear anywhere else. So if you're ready to take control of your health, renew your energy and transform your mind, body and spirit, tune into the Dr. Josh Axe show every Monday and Thursday wherever you get your podcasts. Now, you mentioned in the conventional model, they're looking at TSH and T4 primarily and they're giving synthetic T4 to lower TSH in the case of hypothyroidism because TSH will be real high. So when we look at in functional medicine, we're looking at T3 in particular, which really conventional medicine really does not look as much at. Can you explain the role and kind of the physiology of T4, T3 and how thyroid hormone actually gets penetrates a cell and actually causes the cell, causes the mitochondria to activate cellular energy. Yeah. So if you look at kind of thyroid hormone metabolism, right? In my book, the thyroid reboot, I go into it. I have some really good flow charts and we look at all of the upstream mechanisms as well as the downstream. Because there's a lot of things I call it. It's the domino rally of thyroid hormone activation. So the first thing is we need healthy brain signaling from the hypothalamus down to the pituitary. That involves thyroid releasing hormone, TRH. And so things like lower dopamine, excess cortisol, chronic stress, chronic inflammation, that can impact the first domino. So we want to see healthy dopamine levels. And guess what? Chronic stress or inflammation can take that dopamine and it can bring it downstream into adrenaline, right? Which is a fight or flight hormone. And so for chronically stress, that dopamine can be impaired. So we like to look at organic acids and look at the Vandal Mandela, Homo Vandalate, Jopac Metabolism. That tells us a little bit about our brain chemistry. And also there's certain important B vitamins. If we have an MTHFR issue, B6, B12, these are important B vitamins that help with that neurotransmitter activation. So if we have like an anemia, if we have really, let's say, gut dysfunction, like let's say we have intrinsic factor problems in our stomach, we're not binding up B12 with intrinsic factor in our stomach, that can impact metabolism from a pituitary level or from a hypothalamus level. And then that TRH goes to our pituitary and makes TSH. And so excess cortisol can create problems. Let's say we have low fat soluble vitamin A. Let's say we're a vegan vegetarian. We're like, oh, we think that we're doing a great job because we're eating carrots and we're getting beta-carotene. But that has to get activated into vitamin A. And so things like cod liver oil, grass fed liver, egg yolks, grass fed meat, like really healthy fat soluble vitamins are very important for the thyroid receptor sites at the pituitary level. So TSH is important. If we have high levels of insulin or cortisol or just inflammation, that's going to impact that TSH, those TSH levels. And so then TSH then talks to our thyroid to make T4. And T4 is relatively inactive. So what's T4? It's tetra, Iodothyronine. So the T, tetra that means four, four molecules of iodine and it's mixing with a thyroid globulin kind of tyrosine protein at the base. And so that T4 essentially is produced at that thyroid and it gets activated via an enzyme called didenase. And didenase is what it is. It de-idonase, it takes away an iodine. So it comes in, it's selenium-based enzyme. It's made by the liver. The enzyme comes in and it pulls off a iodine molecule turning T4 into T3. Now with that one little pull off of that iodine, it increases the metabolic activity of that hormone three to four hundred percent. Three to four X. And so now the thyroid is more activated. So 20 percent of that conversion can happen at the thyroid gland itself. Sixty percent can happen at the liver. So if we have low glutathione or our liver is all bogged up because we have non-alcoholic fatty liver because we're insulin resistant or we have, let's say, low levels of glutathione precursors like cysteine glutamine glycine or we have toxic mold or metals, those can impact our thyroid. And plus glutathione does modulate our immune system. And so that can impact theodilol immune system that I talked about earlier. And so the other thing can be impacted by just chronic stress and inflammation. We can have this conversion to reverse T3 that can happen, which could potentially impact the receptor sites. And so kind of going from there, we have to look at that conversion, that T4 to T3. And so we need certain nutrients to make that happen. We need selenium. We need zinc. We need magnesium. We need copper. We need healthy levels of cortisol, not too high, not too low. We need healthy levels of insulin, not too high, not too low. If we have an anemia, let's say low iron or we have low B vitamin anemia, like a megaloplasmic anemia, that can be a big issue because iron is an important cofactor in making that thyroid enzyme, that dehyde nace enzyme. And so these are important mechanisms. And then if we add in, let's say, excess antibodies and also iodine is an important building block too. But iodine is interesting because if we throw too much in it, it can rev up this iodination process and it can increase potential antibodies and increase inflammation because that iodination process can spit out hydrogen peroxide H202. And that's naturally can be inflammatory and increase that B cell. But things like selenium can come in there and it can bind up that oxygen on the peroxide. So it takes H202, pulls off an oxygen and makes it H20, which is water, which is neutral, right? So it's really neutral and healthy levels of iodine and selenium and not too much on the iodine can be really important for that autoimmune aspect. Yeah, and so many people are deficient a lot of these nutrients, selenium, zinc, magnesium, so critical for good thyroid function. So we're getting a lot of that conversion from T4 to T3 in the liver. Now, there's also some in the gut as well. It got my conion pills in big role with this. Yeah, T3 is the gasset and T3 sulfate and healthy gut bacteria makes an enzyme called sulfatease. To their sulfates or sulfatease. And that enzyme helps convert that T4, that T3 sulfate and T3 acetate gasset into healthy active T3. And so good healthy gut bacteria is important. Plus if we have bad bacteria that can also take the enzymes that metabolize or it's just that it's an enzyme called beta glucoronidase in our gut. It's made by bad bacteria. That enzyme takes estrogen that's being detoxified and it releases it back into the system. And so high levels of estrogen because it's not being detoxified can decrease that free thyroid hormone. So it can lower the free T4. It can lower the free T3. That's why women on birth control pills, that can impact your thyroid too. That's why a big side effect of birth control pills are going to be more fatigue, more mood issues because of that. Yeah, absolutely. So I always tell people, if you have a thyroid issue, most likely you've got a liver and gut issue going on. Yes. You've got to address the liver and the gut in order to make sure the thyroid is functioning well. Right? There can be in a kind of an HPA, hypothalmic, pituitary, adrenal axis issue or hypothalmic pituitary thyroid axis issue where the brain's communication with the endocrine system is being disrupted as well. And that goes back to the TRH and the TSH with dopamine and stress and chronic inflammation and obviously sleep and those things make a big deal. And I think that would be different. But also too, I see a lot of functional medicine doctors where people search a symptom. They search a keyword. And so it's okay to put a video or content up where we talk about the thyroid and we act like the thyroid is going to be the thing that you're going to look at. But we don't act like the thyroid is the end dollar, bio and itself destructs within its own system. Other things like we mentioned, the gut, the immune, detox, play a role. But a lot of functional medicine doctors, they market functional medicine, but they're using functional medicine in a very alopathic way by only treating the thyroid. And so it's very important whoever you're working with, make sure, okay, you came in for thyroid issues, but make sure we're connecting the gut, the liver, the nutrients, the stress, the sleep. Make sure other things are being connected to it. You're not just focusing on, oh, selenium good. Oh, thyroid glands are good. I have great news. You can regrow your hair. 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Purellity Health gives you six whole months to try their formula so that you can see this new growth for yourself. Plus, they're currently offering a special buy one, get one free deal back by 180 day, money back guarantee. So six months to try it out, risk free, to access this exclusive buy one, get one free deal and turn your hair follicles back on. Simply visit renewyourhair.com-forward-slash-drj. That's renewyourhair.com-forward-slash-drj. Just start re-growing your hair today. You talked about it a little bit as we've gone through the physiology, but we're some of the main root cause factors for thihypothyroidism. So big thing you're going to see is just insulin resistance. If you go online and type in insulin resistance or just type in diabetes and low triadethyroidine or low or hypo thyroid, you'll find all kinds of studies showing the more insulin resistant or diabetic someone is because diabetes is just extreme insulin resistance. That's all it is. It's on a spectrum. The more insulin resistant you are, the more your thyroid hormone drops. So that's the big thing because we know consumptions of sugar have gone from what four pounds, a year in 1900 to 140 pounds a year today. That's average. So for every person like me and you that maybe consume five or ten, there's someone else consuming 300, right? It's kind of crazy. It's the thick of auto like that. I'd say that would be a big one. Of course, just general stress and inflammation is going to create cortisol imbalances. That can create big issues going on there. Also people that think they're doing their body a good thing by being vegan and vegetarian and they're saving the environment or animals. They're missing so many important fat soluble vitamins, B vitamins, iron. That's going to have a big impact on your thyroid too. So those are two or three out of the gate. And of course, once you have got issues that throws off the immune system because 80% of the immune cells live there and that can impact absorption because just because you're eating those foods, if the acid and enzymes and bile isn't there, you may not be fully absorbing it too. Yeah. No doubt. And then toxicity has got to play a big role. All the microplastics, phallates, all the heavy metals, all the things that were being exposed to pesticides, herbicides, glyphosate, damaging the gut, all of that's impacting it. Glyphosate damages the gut, all these microplastics are going to increase. They're going to decrease our free fraction of thyroid hormone because estrogen's bind up free hormone. And so that's why it's good to have a good reverse osmosis water filter at agger minerals back in or if you're going to drink water, drink it out of glass like a mountain valley or a topochico or a gerocene or a good reputable brand that has glasses good to. Yeah. No doubt. Do you want the TSH to be the T4, T3, free T3? When you're looking at a thyroid panel, where should these levels be? That's a great question. So there's a lot of doctors in the functional medicine world that disagree on this stuff. The first thing is I don't like elevated TSH. Elevated TSH can over stimulate the thyroid gland and cause cell proliferation, cells to grow, think of a goiter, right? So we don't want high levels of TSH. But we have to look. Let's say TSH is a little bit elevated, but your T4 and T3 look good. Let's say you're right in the middle of the functional range with T4. Let's say you're 1.2, 1.3, your T3s are in the mid-threes and you feel decent. You don't have a lot of thyroid symptoms. What do you do? Well, maybe we want to look at cortisol, insulin. Maybe we want to work at nutrients to help the pituitary receptor sites to bring that down. So you have to be very careful with that. When all the downstream looks good and antibodies look good, then you've got to look more at the adrenal and the stress and some of the nutrients. But you don't want that TSH to stay high too long because that can cause cell proliferation to occur. Yeah, basically. Yeah. With TSH resistance is kind of like the first step, kind of like insulin resistance. You could have good blood sugar and hemoglobin A1C could look good. But if your insulin's elevated, we know that's contributing to poor fat burning, poor mitochondrial function, it's contributing to inflammation in your body, thyroid issues. So same with the TSH, we want to make sure that your body's real sensitive to the TSH and producing the right amount of thyroid hormone with the right amount of TSH. Correct. And hypothetically, maybe the pituitary has to stay at that level to keep thyroid normal, to keep it normal. So that's where we'd want to look at the adrenals, look at stress, make sure all the diet and lifestyle and toxicity things are good. Make sure all the nutrients that we're going to be focusing on vitamin A, we're going to be looking at the adrenals, we'll be dialing that in. Now let's say TSH is elevated and T4 and T3 are low. Well, then we may want to start looking at thyroid hormone support. Of course, I'm always like this. It's the order of operations. It's diet and lifestyle have to be there. If I always assume there's some level of autoimmunity, even if we can't test it because there's such thing as seronegative autoimmunity. Or 10% will test positive for Hashimoto's or some level of thyroiditis on an ultrasound. They'll see some inflammation at an ultrasound level, but they won't actually make the immunological blood marker showing TPO or a thyroid gland antibodies. So I always assume there's something going on there and we put people on an autoimmune diet. And we're going to make sure the nutrient density gets up. We're going to look at the adrenals. We're going to do all of the foundational things first. You can think of from water, hydration, electrolyte, sleep, movement, prayer, meditation, whatever, right? All those things are done. And then we can kind of come back and see what we're setting. And then we may want to add in some non-desiccated thyroid glandular or maybe even a potential prescription, if need be, whether it's armor or NP thyroid. And I always recommend starting low. And I always recommend doing it twice a day. Patients feel better with T3 that's more stable throughout the day. A non-desiccated thyroid glandular will have some T3 in it. It will also have pro-demorphogenic proteins, which can be very helpful for thyroid. They'll also have things like calisotone, which can help with calcium and mineral balance. And so it's just going to depend upon where that is there. And then also it's T4 good. What I'll say TSH is a little high. Let's say T4 is good, but T3 is low. And so then we really have to make sure that conversion's there. And if we do give a desiccated thyroid glandular, does that T4 stay good? Or does it go high and then T3 come normal? So it's a little bit of an art and a science there. And that's why you can't just treat the thyroid and isolation. That's why we're doing all of the functional medicine principles first. That's the foundation and then we come here. So if you're listening in and you're like, well, I just want to zoom in on this one part, you're going to miss the boat if you don't do all of the other things first. And this is where someone needs to see a practitioner because it can get a little confusing and a little overwhelming if you don't have that foundation dialed in first. Yeah, for sure. Now we're working somebody start without a practitioner. You talked about the foundation. Where can somebody start without? Yeah. So first thing is get the diet dialed in. Even if it's just whole foods, keeping away any process sugar, being 100% grain free, have healthy proteins and healthy fats at every single meal. Make sure you're meat's organic. If you want to throw in some organ support, that's great. Try to choose more healthy saturated fats. Or if you're going to do any plant fats, keep it cold press, single source, olive oil, cold press, avocado oil, cold press, single source, start there. Try to eat good protein, good fats at every meal. See how you feel? Some people, if they're severe insulin resistance, you could potentially look at doing a little bit of intermittent fasting. If you're a female, you got to be careful because sometimes that can flare up PMS or flare up stuff. The key is if you're going to add in any fasting, you got to still make sure there's enough nutrients coming in. Because if you need, let's say hypothetically, 2000 calories of nutrient dense food and now you're at 1500, there's still a 500 calorie gap there. And again, calories really mean energy. But in my world, every single calorie is whole food, nutrient dense, good fats, good proteins. And so we want to make sure nutrient density is there. I prefer nutrient density over calories because it qualifies what those calories are. So making sure the nutrient density is dialed in. And also, I like using a blood sugar meter. I tell patients, go see how insulin resistance you are. Get your blood sugar meter out, test your meal, test your blood sugar when you're fasting. Are you below 100? The first hour tells you the most because you can 10, 12 hours later, go to your doctor, get a CBC and guess what, or a metabolic panel and your glucose may be under 100 and you're not like one 10 or 120. But in the first hour, we want to be, well, first off, fasting, we want to be below 100. Hour two, sorry, hour one, we want to be below 120, ideally, definitely 140, but ideally below 120 and hour one. Or two, ideally below 100, hour three, definitely below 100. So if we can be back below 100 in two hours, that's a good sign that we are not insulin resistant. And if we're seeing blood sugar above that timeframe, then the things we can do is look at cutting down carbs, focusing on more vegetables, maybe even cutting down fruit, depending on how high that blood sugar is. So I love this approach because now we're individualizing it. We're not like, oh, you're just a low carb guy. You're the paleo guy. We're individualizing it for you. And the blood sugar does not lie. So I like that. And then we can adjust the carbs. We can adjust the fat. We can adjust the protein. We can add in a five or 10 minute walk after a meal back in a lower blood sugar, 10 points, 15 points. Or before you eat, get those glute-forced effortsides primed by doing 15-air squats, right? These are simple things. And then if we're still having problems, we may add in alpha-lipocacid, acromium, venetium, acv magnesium. We may add in blood sugar nutrients to help metabolize that better. And so we really customize that out of the gate in regards to the diet. And then cutting out all the grains and all the dairy, even potentially butter, at least initially. But of course, we want to be able to add those things back over time. And again, if someone is really autoimmune, we're going to have to be more extreme. So just kind of if we see lots of antibodies, we got to be more extreme with the diet. Well, I just want to interrupt this podcast for a very important public service announcement. One of the most dangerous things you may be doing for your health is cooking a healthy meal at home. I know that sounds crazy, but here's what the science says. Most of us are unknowingly swallowing thousands of shreds of microplastic with every stir-fry, egg scramble or veggie sautee. Now where's it coming from? Your non-stick pan. In fact, one-twentieth-twenty-four study found that just a single scratch on a teflon-coated surface can release over 9,000 plastic particles into your food. And those plastic particles don't just pass through your body, they build up in your arteries in your brain and they disrupt your hormones along the way. One study found that people with plastic lodged in their arteries were four and a half times more likely to suffer a heart attack or a stroke. Another found plastic particles, the size of a crantip, inside actual brain tissue, and others now link microplastics to hormonal imbalances and fertility issues. So just like cigarette smoke in the 1950s or let it gasoline in the 70s, microplastics are today's invisible toxin they're creeping into our bodies daily while the science scrambles to catch up. And it's not just old pans. Even brand new non-stick cookware can start shredding particles from their very first use. That's why I switched to the P600 ceramic cookware. It's 100% free from Teflon, PFA's and plastic coatings. It's made with Swiss engineered ceramic and it's truly non-toxic. It cooks beautifully, cleans easily, and most importantly, it doesn't poison your food. If you're serious about reducing your toxic load, this is one upgrade I highly recommend. Right now the P600 cookware is 50% off. And for a limited time, you can take an extra 20% off with the code Safe20 at checkout. Head to chefsfoundry.com forward slash jokers to claim your discount now. But stock is limited and this bonus discount could end at any time. So use the code Safe20saf20 at chefs Foundry all one word CHEFS Foundry.com forward slash jokers before this offer disappears. Your body will thank you, but so will your family. So really focus on that good blood sugar stabilizing diet, nutrient dense diet, starting with that getting exercise, getting movement in, getting out in the sun. Can be really really important. Sun helps charge the mitochondria, vitamin D production, nitric oxide, endorphins, so many great benefits to getting sun exposure and then really also really good sleep, right? Trying to prioritize sleep. Sleep's important. They've done studies that even on college kids where they did sleep deprivation and after one week, kids were pre-diabetic. So sleep helps a lot with blood sugar stability. So think of just as diets a big deal with blood sugar, right? So is sleep. So really be on top of that and you can test your blood sugar after a crappy sleep. Part of it is because you're less healing, you're less recovered because you made less growth hormone. Let's grow the hormone peaks between 10 p.m. and 2 a.m. And you're going to have more cortisol and more cortisol mobilizes sugar. People don't understand, but if you're stressed and you make a bunch of cortisol because of that touch of spots, you're literally. So mobilizing via gluconeogenesis, a snickers bar worth of sugar, 25 to 30 grams of sugar or glucose gets stimulated with an acute stress response. And so if you're stressed or you feel stressed, you better go for a 5, 10, 15 minute walk when you feel it. Clear up that glucose or bust out like I have an air bike and a roller behind me. I'll bust out a 5, 10 minute to body to clear out the glucose from that stress. Yeah. Yeah. So good. This is such great information. Dr. Justin's book, The Thyroid Reboot. So you can check that out on Amazon.com, all the link in the show notes. And of course, you guys can just go on Amazon and look up the thyroid reboot. What can people expect from that book? Yeah. So website is thyroidreboot.com. We'll redirect to the Amazon page. I put everything together. I made the book as I have an autoimmune thyroid issue. I did everything that I put everything in the book that I use with patients. It's the guy that I wish I had when I started out in functional medias and 15 years ago. And so the difference is we connect the dots with the gut with the diet. We talk about how to use blood sugar. We talk about nutrient density. We talk about toxicity. We talk about water, mold, heavy metals. We talk about how cortisol plays a role. Also guess what? Women, if we have estrogen dominance or low progesterone, that also plays a role, right? And men as well, whether we have cortisol issues or we have exerosenosestrogens or low testosterone. I try to connect the dots with all major body systems, infections, line, heavy metals, diet, lifestyle, SIBO, gut bacteria, stress. And I try to go over the physiology. I try to break it down to you as if you were like a doctor or a medical student. Like, okay, let's just make it understandable. What's happening in your body? Because if you can zoom in and understand it, then you understand the application. You understand why we're doing it. It's not just doctors orders do this. Here's why we're doing it. And then we kind of really lay things out in a conceptual way. Because if you understand a concept, you got it. If you try to memorize stuff, you're going to get it on the test and then you're going to forget it. So I try to conceptually and use metaphors and things like that to get the concepts in. Yeah, you're a great communicator and looking forward to checking out this book, guys. You got to check it out with me. The thyroid reboot. Check that out now. Also share it with people that you know and that you care about as well. Dr. Justin, thanks so much for this interview. Any last words inspiration here for our audience? Yeah, absolutely. thyroidreboot.com. That's the Amazon redirect there. I see patients worldwide as well. My staff and I do. So we practice all these concepts with patients directly. This is not just a thought experiment for me. This is like it's a verb. It's an action. We're doing it. We're applying it. So if you feel like you need more support and the book's not enough, you can go to justinhealth.com. Work with Dr. J. There's a button there. Click it and we can see if you're a good fit for care. We also have a podcast and a YouTube channel where we provide lots of great info. So if you want more info like this, justinhealth.com and it'll be more info there for you. Awesome. Thanks so much. Dr. Justin, guys, go check it out. thyroidreboot.com. Be blessed, everybody. Well that's all for this show. And I want to thank you again for spending your valuable time with me today. And if there was something you heard in this interview that you have questions on or you want to dive in a deeper, then doctorjockers.com is the best place to go. If you enjoyed this episode, please consider taking just a quick moment and giving us a great review. Your reviews help us influence more people and transform more lives. And if you took something valuable away from this episode, then please share it with someone in your life you know it can help. We'll see you soon on a future podcast. Be blessed, everybody.