Your Thyroid Labs Are “Normal”… But You Still Feel Sick | Dr. McCall McPherson, PA-C

Millions of people, especially women are told their thyroid labs are “normal”… while they continue to struggle with fatigue, brain fog, weight gain, infertility, and depression.

In this episode, thyroid expert McCall McPherson, PA-C, founder of Modern Thyroid Clinic, explains why so many thyroid conditions are being missed and what patients should actually be testing.

We break down:

• The biggest thyroid testing mistake doctors make
• Why TSH alone isn’t enough
• The difference between T3 vs T4 thyroid hormones
• Why many patients don’t improve on Synthroid
• Symptoms of thyroid dysfunction most people miss
• The connection between thyroid, fertility, metabolism, and mental health
• Why Hashimoto’s often goes undiagnosed for years
• The controversy around natural desiccated thyroid medications

If you’ve ever been told “your labs are normal” but you still feel terrible, this episode could explain why.

🔗 Dr. McCall McPherson, PA-C

https://modernthyroidclinic.com

https://www.instagram.com/mccallmcphersonpa

🔗 Dr. Philip Oubre

https://oubremedical.com/

https://www.instagram.com/oubremedical/

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Transcript

0:00

I think the water's so muddy because, you know, the medical landscape still advocates for TSHv only. You know, TSH is the only thing checked in. 91% of labs, a small percentage of the time they'll check T4. Yeah. That's those too. Literally every every time a patient comes to me, that's what the labs come with is TSH. And I'd say about 20% of the time of T4. Yeah. only 4% of the time, free T3 is being checked, which is your gasoline hormone, your most important hormone. And so I think what's happening in clinicians lives are number one, they're seeing these labs. They are they quote normal right. So they're assuming it's normal. What drives me right. Normal is you can be in the population. You can be debilitated, be normal. With the. Help! Welcome to the Vibrant Wellness Podcast, where we explore the science of functional medicine, advanced diagnostics, and personalized approaches to health. I'm your host, doctor ohm and today, I'm excited to welcome McCall McPherson. McCall is a nationally recognized thyroid and hormone health expert, a Ted speaker, and the founder of Modern Thyroid Clinic. She's also the creator of Thyroid Nation, a widely respected thyroid advocacy platform dedicated to helping people better understand the thyroid disease and find real solutions. what makes McCall's work especially powerful is that her expertise is both professional and personal. After struggling with severe hypothyroidism herself, despite being told her labs were normal, She made it her mission to change the way thyroid disease is understood and treated. Today, McCall helps patients and practitioners rethink thyroid care with a more comprehensive approach rooted in integrative medicine and advanced testing. Her philosophy is simple no one should still be suffering from thyroid symptoms when better solutions exist. In today's episode, we'll be unpacking the deeper connections between thyroid help, hormones, metabolism, and overall wellness. Let's dive in. All right, so, McCall, we have tons of questions about thyroid. Of course, most of us function medicine doctors treat thyroid and everything, but this is your specialty, your expertise. So I'm looking to learn more. But before we jump in, all the things. Thyroid. I know you've got a personal thyroid story. So tell us a bit about how you got into what you do and what you're doing. Yeah. So, like all of our patients at Modern Thyroid Clinic, I was completely debilitated with my thyroid condition. I was 27. I had already been diagnosed. I was on. Right. I wish that would be great. Yes, both of us were 27 just a mere two years ago. So, you know, I was on synthroid practicing medicine already. So I'm a PA and was spending 16 hours a day in bed. So I came home from work every day, went to bed totally like that's was my life. It was work. And literally being in bed enough to recover and prepare for the next day, I was like, oh gosh, I have all these symptoms. I've gained weight, I'm losing hair, I have dry skin. I'm just going to run to my doctor and I probably just need an increase in my synthroid. Not a big deal. Not saying no, of course not. You'd never. This is a small town in Austin, so Austin, smaller than people realize. Saw him and was like, hey, look, I've got all these symptoms, I can't really function. I think I need an increase. And he tested mission was like, actually, McCall, your thyroid labs look great. Totally normal. No changes needed. Not that. In fact. Hey, your test is a little low. Maybe we need to. We should decrease your meds. By the way, you have a cholesterol issue. I'm going to go ahead and put you on Lipitor. Oh, yeah? Is that fixes all kinds of problems. Right. And I broke down and like, cried in his office as many thyroid patients do and left and was like this can't happen. Went back with a posted I had done research back then like thyroid advocacy platforms didn't really exist. Came back with a little posted of hey, could we look at more numbers? Could we go deeper? Maybe it's something different to a full thyroid panel? And the answer was no. So I got on the waitlist for a physician back then who was one of the only docs definitely in Austin that specialized doctor Manson. Arrow. Yeah, Ron Manson, arrow I know you know him. I know it's been a long time. He's like insane or Kerrville, I think. Yeah, yeah. Saw him, waited a few months to see him and got my life back. He immediately became a mentor to me, and I just devoured anything and everything I could in the literature about thyroid, the OG functional medicine of Austin. He was. Yeah. Before it was called functional medicine. Yeah, absolutely. Got to pay homage to those guys because, gosh, they were doing all this before we had fancy stool studies and vibrant testing and yeah, kinds of stuff. Man, I, I'm glad we're in the era in MeToo and still grateful to him to this day because I wouldn't have my business. I don't think I'd have, you know, babies, so many things get compromised, which we can chat about later, but anyway, I it changed my practice of medicine. And over the years, honestly, my patients sort of created modern therapy clinic for me before I was ever overtly just focused on that. And here we are now like about a decade later and just changing lives. It's super fun. I'm grateful my original doctor, Doctor Steve, that I came to work for, he taught me some profound things when when I was a young buck and, he's he said that same statement. He said, well, Phil, if you're going to attract the patients that you like or you're good at or whatnot, and I was like, well, that sounds totally stupid. I'm just going to like whoever shows up my schedule, whoever falls, that's what I'm going to see. But he is right. The type of things you put out there are the type of people that start to come to see you, and the ones that don't want that just naturally leave. So he was he was absolutely right. And so that's kind of what happened with you. You started attracting more thyroid patients and then just made the leap to start your own practice. Because that's not easy to do. What's crazy is I was practicing integrative and functional psychiatry and I know that was my niece. I'm not kidding. I know, and slowly, like 80% of my new patients were for thyroid issues because I had treated enough treatment resistant depression patients for an underlying thyroid issue that just hadn't been diagnosed. They'd taken my information and spread it all across these thyroid advocacy platforms that were really early on. There weren't a lot of people and I'd get excited when thyroid people came in to see me. And eventually my first out-of-state patient flew in and I was like, oh my God, I'm doing the wrong thing. And from that modern thyroid clinic was born. So really, I mean, it was crazy. I had never marketed myself in the world of thyroid, but when you change people's lives, I'm sure you have this experience. They go in, they tell everyone about it. Yeah, that's the word of mouth is the best marketing. And that's also how it confirms and validates you that like, oh, I'm actually doing good work. Yeah. Because if I did that word of mouth, that means I'm not doing a job. Totally. Because there's always haters out there, always people telling you that you're not doing something that's that's conventionally studied and approved and whatnot. That's interesting. And that brings up a thing I say frequently is that depression is a diagnosis. And nowadays. But mental illness is often a symptom of many other things going on. And unfortunately, that's conventional medical world. There's a lot of patients out there that get their antidepressant, whatever it is, from their psych doctor or primary care doctor, and they just fully believe it. So let's give a perfect segue into doing more thyroid testing. Looking further. So, with these patients, whether it be let's not even do mental illness only let's start with, what are the common things people should be when they're experiencing? You should be looking further into the thyroid. I love this question. I love it because I think this is missing in so much of the conversation that we are even having or not having today around thyroid. So what I think people don't understand is your thyroid is responsible for most every big health outcome in our physiology. Even subclinical hypothyroidism, which is like mild hypothyroidism that medicine doesn't think we even need to treat. I'm glad you said that because remember, we've got patients watching this and only doctors. So, so say that again. Subclinical hypothyroidism isn't. That's huge. Yeah. So subclinical hypothyroidism is just defined as an elevated TSH with a normal T4. So what patients will experience in that regard is they'll go into their doctor's office and they'll be like, you know, your numbers are a little off. It's mild. We don't need to do anything about it. We'll just watch it. And that often happens for like a decade before there's an intervention offered. And it's not benign like subclinical hypothyroidism is even mild. Hypothyroidism is linked to a 68% increase in heart attack, a 37% increase in cardiovascular death. No. And like, you know, we all need to be worried about heart disease, right? Like it's still the number one killer. It is. It is. We're trained to be so afraid of cancer. But heart disease kills, you know, more every more people every year than all forms of cancer combined. So it's a big, big deal. So when we know that your risk is increased that significantly from a condition no one wants to treat you for, it's a big deal. So I mean, I think no harm in even trying. Right. That's that's the the wild right. It risk versus benefit is always you know, the benefit far outweighs the risk with thyroid when you're in the hands of a knowledgeable clinician. Fortunately right now with guidelines drives it. Amen. That guidelines that haven't been updated in over a decade by the way. Yeah. And longer. Right, right. No. Absolutely. The minimal in my training, one of the things that always frustrated me as I got more into holistic type medicine was the endocrinologist. They don't treat to age until it breaks five, but when it does break five, they treat it down to two, right? Okay. What about the patients between 2 and 5 that haven't started treatment yet. So if you're on treatment three is a problem. If your off treatment three is not a problem, right? Logically that doesn't make any sense. It makes no sense. And now there's advocating for not treating until people's DSH is over ten. So imagine the consequences. Obese on disability, unemployment, fatty liver and infertility. You know all of these things were waiting to intervene based on incredibly flawed science. And more and more people are, you know, waiting for that intervention as time goes on, because we're further, strangely, trying to stratify patients outside of treatment eligibility as opposed to narrowing those margins, which was what was happening ten years ago. We're going the opposite direction now, which is bizarre. Oh, yeah. To, conspiracy theory, but like, why? I know thing the the allow is it because it sells more statins and other stuff like why would anyone want to to stick to ten before they get treated? I don't know, can I tell you about the study that kind of turned us in that direction? So you probably remember this because I know you were practicing. I was referring you patients got long ago, but there was a time where we were starting to narrow the margins of thyroid labs. We were starting to consider combination therapy more and more. And then in 2018, not even a huge study, but a study came out that kind of changed the landscape of thyroid. And it was, look, we're treating people. They're not getting better. Their quality of life scores, their symptoms are not getting better until there is over ten. So what it advocated for was stopping treatment until people's TSH was over ten. So there was a massive inherent flaw in this study that no one talks about, which was they assumed that the treatment they were giving these patients works, right? They were all getting levothyroxine based meds, all synthroid for those of you listening, that's a completely inactive medication. It's dependent on your ability to activate it. The vast majority of people can't activate it very well. Think about it like crude oil. We don't put crude oil in our car like that metaphor. Good metaphor. How I ended up with automotive metaphors are motors all the time and would have like this really masculine man in front of me. Right. Please don't make me go further. Right. I think I'm breaking this down a little. Well I serve for women. So it's it's kind of ironic, but, you know, it's like crude oil. We don't put crude oil in our car, but we need it to make gasoline to put in our car, to make it go. But it's got to be gasoline before we go anywhere. So we are giving the masses crude oil hormone. It's one of the top five most prescribed medications in the country every year. Oh yeah, a lot of times it was like number one and two over the last 6 or 7 years. Yeah. So on this study, these people were getting a medication that was presumed to work. It doesn't. And instead of saying, hey, maybe the medication we're giving people isn't working, they assumed it did and said, let's just stop treating people until or worse because they're not getting better anyway, which is crazy. Now, that study has been cited in over 300 subsequent studies to further again remove people from treatment eligibility. So even if that is a research I'm going to hate on doctors for a second, I'm a little disappointed in my profession, even if that guideline comes down the pipe. If you've been practicing save more than a month. You've seen a patient change when you get firewood. Everyone has. Yeah, even dating back to my basic family medicine days of only checking. TSH, you've seen a patient transform. I give the thyroid hormone. And so hopefully enough of us have brains to see that. Okay, this guideline came out, whatever it may be, but I'm not going to change my practice because of that. But I'm assuming you're talking about this because it's happening out there. There are people with our brains that are actually following this pipeline. It's true. Right now there's a lot of people following the guideline And I think the water's so muddy because, you know, the medical landscape still advocates for TSHv only. You know, TSH is the only thing checked in. 91% of labs, you know, in, you know, a small percentage of the time they'll check T4. Yeah. That's those too. Literally every every time a patient comes to me, that's what the labs come with is TSH. And I'd say about 20% of the time of T4. Yeah. And it's questionable whether it's free or total. Solutely. Absolutely. And only 4% of the time, free T3 is being checked, which is your gasoline hormone, your most important hormone. And so I think what's happening in clinicians lives are number one, they're seeing these labs. They are they quote normal right. So they're assuming it's normal. What drives me right. Normal is you can be in the population. You can be debilitated, be normal. And then 90% of the population out there, right. Normal is based on the right people in Cleveland or something. Exactly. We're in the bubble in Austin. Of course, now our population is a bit healthier. Yeah. Every time I come downtown studio, I'm always reminded how healthy yeah. Awesome is. Yeah. Keep going. Yeah. No. So we're we're not checking enough information and then we're also trained. Hey, you know, thyroid symptoms are nonspecific. If people have persistent symptoms and they have a normal TSH or a normal T4, it's something else. So we write these people off. Sadly, women are gaslit. They're sent on their way. They're told the same thing that I was told, here's your Prozac. Eat less, exercise more. By the way, take Lipitor for your cholesterol problem. That's actually a manifestation of your thyroid condition. And we both know that. But but say that again because I think most people listening would not call it that. Yeah. So, you know, women are told based on inappropriate, inadequate lab data that their thyroid labs are normal, that all of these symptoms, they're prediabetes, their cholesterol, their metabolic issues, their depression are due to something else, not their thyroid, and go manage those symptoms that are simply a manifestation of a root cause of a thyroid condition. Go manage them on your own. And yeah, we're no not not of any service, not have any help. And now you're not on the treatment you need, which is thyroid replacement which we'll get to the details. But in addition now you're on other medications that literally have side effects that make you feel worse and actually don't necessarily extend your lifespan. As you point out, 68% heart disease is a 68% increased risk of heart attack, 37% increased risk of cardiovascular death from just subclinical hypothyroidism. Imagine hypothyroidism, right? And now they're on a statin, which does not have that much benefit. Conversely to what they say out there. Okay. Fascinating. So all right, so women are being gaslit into. But yeah, you know, you seem to know the percentages offhand, but what's the female male ratio? Do you know. Yeah, I think it's eight for eight women for every one man. Modern thyroid clinic is like 99.9% women. The only men that end up with us are men whose wives drag the men. I know that I don't I don't know if this is research or not, but I typically say adrenal issues, stress issues on that in men cause low testosterone and women hypothyroid first, at least kind of what I've seen over time or that's true or studied, but it's kind of what I see. And so by the time a man's thyroid is off, their testosterone has been pretty jacked for a while. Absolutely. Okay, so lots of symptoms I keep want to jump to my next question that keep coming up. So try not to go too fast. As far as symptoms you said some of the big ones. So let's say some of the big ones. What are the big low thyroid subclinical thyroid symptoms that everyone needs to be aware of. Yeah. Good question. So it's the classic fatigue. It's brain fog where you just feel like you can't think dry skin, brittle nails, brittle hair, hair loss, low libido, depression, constipation. Often people go to their, their doctor and they'll say, oh, your blood sugar is increasing, your cholesterol is increasing. We'll keep an eye on it. They're often cold. And then people with Hashimoto's especially, which is the autoimmune condition associated with hypothyroidism. And we can dig into that if you'd like. They yeah, they have anxiety. It's a pretty common manifestation. And sometimes people will have like swelling in their lower neck where their thyroid is. That can be what's called a goiter knock. You know, I used to have a massive one myself. Really? Yeah. You'd be shocked if I showed you, like, a photo of me in the throes of my thyroid. I'm not really recognizable. It's pretty sad there, too. Absolutely. Fine. That's just going to happen. Yep. That's it. That's, So what? Now, you said it earlier, but I'll make you say it again. So those are kind of the classic obvious symptoms, but the thyroid is kind of responsible for everything, including just the metabolic speed. So what are some not so common symptoms. Because the other thing is all those symptoms can also be explained as aging. Right. It's people often well, I'm just 30 now or I'm just 40 now. And so I'm glad you listened to The symptom. But what are maybe some uncommon symptoms that people should at least consider? The thyroid may not always be the thyroid. That could be. Yeah. So a lot of these are kind of health related right. Like like I mentioned cholesterol blood sugar. People don't think when they go to their doctor and they're 35, 45 and they're getting told, hey, your blood sugars increasing or your cholesterol is increasing. They don't think, oh, well, maybe I have a thyroid issue, right? So that for women PMS, so low thyroid triggers low progesterone. So you get anxious, you get agitated, you get irritable leading up to your period. Irregular cycles, infertility huge. I'm sure you see this all the time, but mild, mild thyroid issues result in infertility, recurrent miscarriages, and the data backs that up. Like data shows. Really? Look, your TSH needs to be at or below two if you're trying to get pregnant. Depression, anxiety. Again, research shows your TTS should be less than two. No higher than 2.5. If you're depressed and have a thyroid issue, cracking on the bottom of your feet is kind of a a not often realized one. And then never now on the bottom of your. Yeah, yeah. And then loss of the outer portions of your eyebrows. Right. Like those are some less commonly known ones. And then what I say to you is you're so right. In medicine we're trained. This can be aging. This can be, you know, nonspecific. And that is how so many women especially but men to kind of get dismissed. And I always say look like if it looks like a duck, it walks like a duck, it quacks like a duck. It's probably a duck. So if you have a constellation of these symptoms, most likely you have a thyroid issue. And in all my years of practicing, I have turned away one person, one person that came to modern thyroid Clinic thought they had a thyroid issue and they didn't. Everyone else that comes thinks they're so afraid when they sit in that first appointment where we review their labs that I too am going to tell them everything's normal. This isn't your thyroid, this is in your head, you know. And everyone that comes has been told by usually numerous people, it's not your thyroid, but I've only ever turned away one, so there's something to it. There's something to look. If we are looking for optimal checking the right labs, using the right lab ranges, then and people are outside of those, then they probably do in fact have a thyroid issue in their lives. Change as a result of proper treatment. I think another part to lab testing that you didn't say just there is you kind of already said it, but to say it again is you ask questions. Yeah, like if it looks like a duck, quacks like a duck. Even if the lab values don't fully match, what's the harm in trying? And if they get better rate if they don't. Okay, go park up another tree. But, another thing as far as gaslighting, I've had patients and I'm sure you have the same, where they would come to me on a thyroid regimen and before we even get to talk about it, they're being all defensive about their regimen and almost afraid that I'm going to change it. Yeah, and I have to disarm them and say like, hey, I'm not that doctor. If you're happy on something, why the heck would I change it? But that tells me someone else has attacked them. Yeah, about the regimen and told them that that regimen was bad for them. And I don't know how we got to this place. I don't know how we got to this place that doctors bark orders like you know better than someone else's. They're in their own body, right? Why would someone want to take something? I guess there's all kind of that. That's a different story. But why would someone want to take something that's literally harming them and making them feel worse? So. So it was a question. The question is, do you come across that where people are scared to change their regimen, scared you're going to change their regimen? You know, it's interesting. I mean, something magical happens when like they come in and they know that this is your thing. And I think what's unique, too, is social media can be so powerful on this front. Right. Like people know what to expect now before they come to see us. They know how we practice. They know how our mind works. So I think they come in feeling pretty safe. They're just scared we're going to tell them the same thing everyone else tells them, which is you don't have a thyroid issue. And in fact, after watching you on social media, that right, right there, I think they're so desperate by the time they come to see us that there is no one to go to after us. And so they're like, look at these people can't help me. No one can. And it's honestly crazy. I'm not exaggerating when I say this, but 95% of women during that appointment where I review their labs with them for the first time, tell me one of two things whenever I tell them about their labs, number one is, so you're telling me I'm not crazy in that nuts. And number two is. So you're telling me this is not in my head? How awful that that is 95% of women's experience before they come to see us. Yeah. They cry. Yeah. You know? Yeah. They cry. Job security. Right. Job security. I know that's the good news for us, but unfortunate. And that's why we're doing this right from the rooftops. That. I hate to say it, but if your doctor's telling you these things, he's not your doctor. We'll find another one. And someone else. Keep looking. Look for answers. Yeah. So in this world, I think it's time to pivot from from symptoms. I've been diagnosed as question. So all right. People have heard these symptoms like, okay, they're checking the boxes and I go give it. This might be me and I, my doctor may not test these, but I'm going to go test these myself. So what are the tests that specifically that a patient watching this should go and look for. And if they're doctor order it, go to their own lab and check their own boxes and pay for it out of pocket. Amen. I can't recommend people do that enough because we live in a day and age now where what your doctor will or will not check is not your only option, right? So everyone should have a TSH, everyone should have a free T4, everyone should have a free T3 reverse T3, and that's like a thyroid function panel. And then honestly, everyone needs to be worked up for Hashimoto's. That autoimmune kind of component, which is TPO or thyroid peroxidase antibodies. In thyroid globulin antibodies you'd be shocked how many people see me. And they're 15 years into their thyroid journey and no one's ever checked for Hashimoto's in conventional medicines defense. Why would you check? Because there's nothing you can do about it, right? They don't do anything. So why check one? Check. Meanwhile, I'm just in remission over here for, like, over ten years, you know? So most people don't even believe that's possible, right? I still don't believe that is possible. Screaming from the rooftops. I'm sure you've posted social media. I post on social media. I'm constantly surprised how many people do not realize that our immunity is reversible, and I still understand how Endocrine Society is and all that, with us screaming it from the rooftops. Like what I don't understand, what's the what's the reason for not believing? Well, it's complicated and you can't do it in like 4 to 8 minutes, right? You can't you can't deal with complex non procedural based medical problems. That's your answer. That's I know in 4 to 8 minutes. So they're just not invested in it I guess. Yeah. Okay. So many questions so many questions. So now we're going to run that list again, which you're going to give your preferred ranges about as much as you want to. That will let people hear it again. Actually, before I do that, has anyone ever told you I'm sure they have that reverse T3 is not a real thing. Absolutely. All day, every day. Are you kidding? And specifically, I mean, doctors, other professionals have told you that reverse T3 is not a real thing. Absolutely. And you know what? It's so important. And I'm sure you found this as well. Our mainstay of treatment is levothyroxine based meds. Right. So this is levothyroxine synthroid unit thyroid tears. And it's all the same. It's all crude oil I worry about it because everybody's listening. They may not even know they're on levothyroxine right. Live axle tube is another one. This I stopped this in for you, right, I love it. So this is a crude oil hormone. Okay, so what happens if we go back to the. We're back to crude oil. Metaphorical. This time it's real, right? Right. I'm going to give you a bunch of crude oil and. Okay, I thought you're going to say the drug was derived from. No, no no no no thank God. Nope. Maybe. Who knows. Right. Metaphorical crude oil. Yeah. Metaphorical crude oil. If I gave you a bunch of crude oil and you couldn't convert it to gasoline, what are you going to have? You're gonna have a bunch of crude oil in your garage, right? And up and not going anywhere in your car. Well, crude oil hormone, your T4 is a reservoir to form reverse T3. Okay? The worse you are at activating a medication like levothyroxine, synthroid, etc., the more crude oil you're storing in your garage and the more of a source for reverse T3, you have reverse T3 is shaped just like T3, very similar in an opposite orientation like our hands mirror image. So what that allows it to do is bind and land to the same landing spot as T3. But instead of activating things like your energy, your mood, your libido, it sits there and it doesn't let T3 bind. So now what the general medical system is doing is not allowing people to get a lab saying it's invalid. To get a lab, that is key, especially for anyone on the mainstay of treatment for thyroid, because those people are at the highest risk for elevations in reverse T3, meaning they absorb even less of their gasoline hormone. So it's incredibly, incredibly important in the literature. It's largely studied in relation to ICU patients, which I'm sure you're aware of. Yeah. So reverse T3, I'm going to go off on a tangent. Right, right. We're all just occasionally in the ICU. Right. That's that's where the bulk of the research is done. And they say it's not important unless you're in the ICU. So don't check it. But what's fascinating about reverse T3 is it's a purposeful mechanism in our body. So when we're stressed, when we're inflamed, when we're micronutrient depleted, when we're calorically restricted over exercising, pregnant, breastfeeding, sick, our body drives up reverse T3 to make us tired, to make us lay down, to make us rest and make us recover. And so it's purposeful. The problem is, now everybody's on the source of reverse T3 on levothyroxine. And we're all we're all stressed, we're all inflamed. We're all micronutrient depleted. So reverse T3 is a chronic, pervasive issue in our country. But no one's checking it enough. It's checked less than 1% of the time to actually realize, hey, this might be an issue. So I'll get off my soapbox on that and we'll move into where I got more questions. Okay. Go ahead. Okay. So I want to point out a couple of things because you say things quickly. And yeah, patients picking up on how important that is. Unfortunately, especially with women. Yeah. The social media has you guys thinking that you all need to be pencil thin, anorexic and unhealthy. Yep. To be the best looking version of yourself. Yeah. So you said calorie restriction is something we talk about in the practice. All women are constantly shocked when we tell them, like, you're not eating enough. Yeah. What do you mean? I have to eat more to be thin. And I think you just kind of nailed the hormone cascade. Yeah, so I didn't want to talk about it, but I wanted to give you that. Can you talk more about this reverse T3 calorie restriction, also known as under eating. Yeah. Yes. Go. Yeah. So when you calorically restrict when you over restrict your diet. When you don't get enough nutrients, micro macro all of it. When you're over exercising. Right. You're problem. And it's a very under eating necessarily but over exercising got increase in nutrients for sure. I don't have this problem I don't know. Me neither. Well, I go for a walk. I'm hungry now. All right, I know I lift weights and for three days I'm, like, ravenous. You know, so basically, your body metabolically shuts down. It puts you into hibernation mode. When you do that, it wants to preserve resources. Right. So just think about, you know, 100, 500 years ago, a thousand years ago, our body has to adapt when we don't have access to enough food and it slows our metabolism, it slows that burn, makes us go in, almost hibernate, puts us into that hibernation state. And so our metabolic rate drops. And so you do this chronically and you walk around with an elevated reverse T3 free T3. Your gasoline hormone is the pillar. The foundation of your metabolism in almost every way. So blocking the absorption of that by overly restricting is incredibly damaging to your end goal. And I'll tell women this, some of the highest reverse T3 I have ever seen are from caloric restriction and over exercise. Yeah. So now you have to talk about the normal range. Yeah that is reverse T3 because it's shocking with the normal range is for T3 on a lab. So yeah pays for it. They're there to see the reverse T3 and they're gonna say oh it's normal no problem. But before you address that I do want to say most labs for everyone. One is based on 90% of the population. That's all it is. They just go get a thousand people. Actually, they do med students all the time. They'll come right back. Hey, you want to be part of the study for our lab to determine what? Yeah. Yeah, sure. I mean, while I'm eating hamburgers and crap. Yeah. Don't don't don't blame me. But it's just based on. We checked a thousand people and 90% of those people are within normal ranges. And what's fascinating is I do a bunch of labs through Cleveland Heart Lab and Quest, and it's interesting how you'll see different reference ranges from each lab. And it makes you realize, like, this is not a studied thing. It's just based on whoever, their population is a virus. They're they're Zoomers. They get to do more, I should say studied. They they get to kind of create their own lab value ranges because they care about people's balance and things. And so, anyway, that's enough monologue. I want to hear what the normal range is for you. What do you expect people that, to to see? I want to build off of that just for a second, because you're spot on and people don't know this. Just thinking about that in, in relative to thyroid, a couple things. Number one, there are differences between the same lab and different locations. West by your house is different than quest by my house, even though we live in Austin. Isn't that crazy. And so when they're taking these averages based off of patients in their database, we also have to think about kind of like you alluded to, who's going to the lab. It's not people who are like, I feel so great on this Monday afternoon, I think I'm going to take a half day off work unpaid and go get my thyroid labs tracked because I'm just curious. I feel so good. I want to know know it's people who are sick who are looking for answers to their own health. And that's our normal. That's who we're comparing, comparing things to. Right. And you know, second, they're not really they're not excluding people with the condition that they're trying to rule out. Meaning people with hypothyroidism are lumped into that average, which further widens the scope. Right. So at modern Thyroid clinic, ten plus, probably 12 years ago now, we started with similar ranges that the functional medicine world started with and found pretty quickly that people were persistently symptomatic. So every 12 to 18 months since then, I narrowed those margins little by little based on our patient, our population data of where do people have symptoms, where do they not? And now, you know, ten years plus later, we're left with optimal ranges that are so incredibly small. We find if we get people into them, they truly do get their lives back. So our ranges, you won't find them other places because they're ours. But yes, age should always be less than 1.8. I find if people's TSH is it? I know 1.8 at 1.8 and above, people are symptomatic. It doesn't matter what their other thyroid labs are, so free T4 should be between 0.9. Yeah. Again free to. Yes. Total garbage. It's free T4. It's not the same. Nothing else that nothing else matters. Yes. Between exactly. 0.9 to 1.2 for free T4. You know that that cap at 1.2 is incredibly important for people on levothyroxine based meds, because they tend to accumulate too much T4, which dumps into reverse T3. So, I like that, free T3. I got nothing else but free T3 should be between I know right scream it for all a vibrant wellness to know. Free T3 should be between 3.6 and 4.2 for the bulk of people today. Meaning if you're on a T3 based medication like armor or site AML and you check your labs at peak, that T3 is going to be above that marker because that peak is short lived. So there's some nuance there. But for most of the day, people need to sit in that range to thrive and feel good. And then reverse. T3 should, in a perfect world, be between 8 and 12. If you have plenty of T3, it could go up to 15. The regular lab will say it can go up to 24 very often, sometimes 28. Yeah, which is horrible. It's crazy and bound. Yeah, yeah. I don't know if you believe this, but I normally tell people that they can, stress they can mentally stress themselves. And for a first year of about 18, anything over 18 is generally metabolic. Like what I mean by metabolic, like something worth more important going on, like calorie restriction, something not just, oh, stressful day or too much synthroid like too much levothyroxine. Yeah, that shouldn't be a thing. I know we should talk about that. Like I would not be an issue. I know, and it's actually linked to so many poor health outcomes and we're taught in medicine OB so afraid of T3 too much. T3 is linked to all these side effects and cardiovascular risk. Yeah let's talk about it. Next thing is all right so how do you tell all these patients that when you're using T3 medications which I'm going to want you to say the medication. In the number two is of course these patients are going to go see other doctors, the conventional doctors. And they're going to hear things I wouldn't say I'll let you say like what are the scary things about T3 through T3 medications that you need to some. Yes. So T3 based discussion. It could I'll shorten it though. Don't worry I won't I won't lock us in here for like three hours for the full interview. So you know, T3 based medications are active thyroid hormones. They're the gasoline hormones, right. And they're things like sight smell, like irony, which is pure T3. There are drugs with thyroid. We all get that though. Yeah I yeah this T3 thank you for that. Didn't even think about it when you say these break thousand times a day I do, I do. And then there's another class of meds that's like a combination that has T3. They're called natural desiccated thyroid. They come from pink thyroid gland. These are meds like armor and thyroid run thyroid. And they're part inactive part T4 and part active T3. So any of these meds have T3 in them in medicine I'm curious if you echo the same thing, but my training and the training of our board certified endocrinologist, that's our clinical director at Modern Thyroid Clinic was never use meds with T3 and then only use T4 based meds. If you put your patients on T3, you'll give them a heart attack. I'm ashamed to say I didn't even know T3 existed. Yeah, right. Because we're we're not trained of them how to use them, and we're trained to be very afraid of them. Never heard of armor. When I started working for doctors, they used a lot of armor. And that was my introduction to T3. I did a lot of research when I landed in Austin. Like, what the hell? Yeah. What is this world I've never seen before? Yeah, we certainly wasn't checking T3 and family medicine. We were taught that you don't order a lab unless, you know, it's going to be abnormal. Or it's part of the guidelines. Right? So, yeah, we didn't even have to say it was. Not even. We were taught never to check DSH unless you suspect I've been iron read on screen. Yeah, that's true. Wow. That's crazy. We're talking. Just not even TSA. So everyone needs a screening thyroid panel, right? We all need that. So, you know, and it's cheap. It's not that expensive. It's so cheap. T3 is the most expensive part. But I want to say, even if you pay cash, please. I realize that's one of the things insurance companies have done really well, is move people into believing that you need insurance to get these things done. You find out the cash price and then like 120 for all for markers. Yeah, I can get as low as 68. And I'll tell you this, clinicians too, when you go to them and you ask for a full thyroid panel, they'll tell you that insurance won't cover it. And that's absolutely not true. We run for thyroid panels every three months on 100% of our patients until they're stable, and it is always covered by insurance. But what happens is, if a clinician in an insurance model runs a lot of full thyroid panels, insurance will go to them and say, you're ranking up, you're racking up too much cost here. This is too expensive. If you keep doing this, we're going to drop you from our policy. And so that is where the threshold in the issue comes up. But it's not lack of coverage. So that's a fear. It is infuriating. It is infuriating. So back to your question. Now I'm trying to remember what your question. Oh yeah with T3. Yes. So what do we need to be afraid of T3 for real. And then what is your clinician likely going to tell you about T3. So in our medical training we are trained that T3 can increase a cardiovascular arrhythmia called atrial fibrillation, which increases your chance of heart attack and stroke. That fear is pervasively spread across medicine. Pervasively. Yes, it is profound, like it's a direct link. If you take that drug, you will develop that. Yeah, you'll kill your patients, right? That's what we're trained. T3 is incredibly safe. And in fact, like you have to you one have no idea what you're doing to medically negligently practice medicine and use T3 in such crazy high doses that it could, in fact, trigger that. That's not some, you know, 2.5 or 5 microgram of ML too high. No, this is ten times 100 times appropriate amounts of medication. But in the lab not checking the lab. Right. Let's check. Labs have that in their brain. Just normal. Okay. But if you're just not checking, that's how you get that right. And it can get there because people are checking labs off meds, and T3 is short acting, so that can be an issue. The other thing is I want to talk about is timing. Yeah, yeah. You want to get to the left side for sure. So high T3 AFib and that's true. Like if you get a crazy high T3 you can get AFib. But what's fascinating this is going to blow your mind. And I can send you this study if you want. There was a huge study done on thyroid patients. I think it was in Denmark that showed elevations in T4. So the meds that we use all the time that we are trained are so safe, nothing bad can happen. Increase cardiovascular risk, all cause mortality, unemployment, early retirement, and diabetes. Higher levels of T3 within like normal ranges, lower cardiovascular risk lower all cause mortality. Lower or increased socioeconomic status. Reduced risk of early retirement, and reduced risk of osteoporosis. Osteopenia also, T4 increases risk of osteoporosis. Osteopenia I can confidently say that is 180 degree opposite of everything I was taught in my medical training, and I think every clinician that I know would echo the same thing. And what I hear is on T4, only you don't feel good. You know, T3, only you do feel good. So you keep working, you keep doing all of those things. That's just a logical even if you don't have labs and whatnot to prove it, you just feel better. You do it. We've lost that in in medicine the art of just Asking questions. One of my rules and in my new patient visits, kind of drives my new patients crazy is I tell them I don't want to see any labs in the beginning, because I just want to hear their story, and that takes them by surprise. And part of that is because I want to tell. I want to like, okay, we know, we know. I don't know what what I don't know. And if you show me something, I'm going to hone in on it. And I don't even want to look at, like, just talk to me, tell me there's so many labs we can run. Just like asking patients. Are you tired? How about that? Right. Yeah. I think we. I don't want to say I think we can fast. Yeah, maybe we haven't lost it. Maybe it's just the insurance model that, like you said, 4 to 12 minutes. You know, you should ask, but you don't have time, right? And that's why I agree. And that's why I think people want so badly great care in an insurance model. And I would love that for them too. But me, for example, I think it's the same for you. I cannot effectively do my job. The clinicians at Modern Theory Clinic cannot get the same outcomes in an insurance model, because we do not have time to sit with these people to understand where they're coming from, to understand their history, their symptoms, or educate and empower them. And I know that's just in the world of thyroid hormones. I can't even imagine in your model where you're taking in all of this information from all these different aspects of their physiology and trying to conduct a true history and come up with a solution. And even if it were easy, we were still treating him. Connect with them. And so even if you could do your job in 12 minutes as far as like prescribing the right drug, you can ask the right questions. You lost the connection. I'm shocked at how many patients tell me like, hey, my doctor has such a foreign accent, I can't understand him or her. She doesn't even know he or she doesn't even. Look, there's time. The computer. And I'm so glad I was able to get out of the insurance model, because that's just that's bonkers. My my short visits now, which feel too short. 30 minute. Yeah. I complain like, oh, gosh, we only have 30 minutes. Yeah. And I still remember the day, as I'm sure you do too. Yeah. It hurt my soul. Oh wait, I was going to become a general contractor and flip houses for a living. It absolutely was unsustainable. I didn't want to do it at all. And what's so interesting I did a Ted talk like gosh, literally ten years ago now a Ted talk. Thanks. I should clarify, Ted, not Ted. So. Okay, any Ted zero. So I pulled all of my patients and I was like, hey, I want you to tell me the most impactful part of your care with me. Was it changing medication? Was it supplements? Was it lifestyle? Was it being treated like a fellow human and a friend? And it was 78% of them said it was the human connection piece. And so you are spot on. That is missing. And not only is it missing, it is incredibly healing and therapeutic. Yeah, I'm sure you have the same thing where patients leaving my office after the new patient doesn't feel better. Yeah, we haven't done anything that we did. We connected with them. We earned them. Yeah. Let them tell their story. Even if 90% of the story was totally superfluous and I didn't need it. They needed. Yeah. I, and so I love that about what we get to do now, because I didn't do that previously. I feel like we've gone off track. And so I want to go back to it, which is great. That was. It was still got time. Was there anything else you want to say about this high, thigh high T3 situation that doctors are scaring patients? Do we miss anything? I know, I think the bone issues. That's why people always come to me. Oh, my mind acknowledges that my bones are going to rot away if you use this drug. Yeah. No. So high T3 high normal T3 is associated with improved bone density. Period. Full stop. End of story. High levels of T4 is associated with loss of bone density. Both of those are independent to TSH, the research shows. So a lot of this DSH based fear to you is is not a real story. Which makes sense, right? If we're thinking about the tissue, your hormone that your brain sends to your thyroid, not really directly thyroid hormones anyway. So we need to look at free T4, free T3. And again, I think the biggest in my opinion, the most common way women end up with crazy high T3 that actually could be harmful is years and years of checking labs off of medication, artificially showing a low T3 and unendingly increasing patients T3. Yep, go back to that. I circle that on on and then what is your preferred timing? I read medication, so I with labs we are way outside of the norm. So when I first was, you know. Yeah, coming into this field, the norm is not good. The vast majority of people are checking labs off of meds when they have T3. This is very much less important with levothyroxine synthroid you know, 30% with T4 basements. Half life is, you know, 7 to 10 days, meaning doesn't fluctuate hourly when you check it. I mean you could check it after you didn't take it for a full day. T3, on the other hand, peaks and troughs in about roughly 5 to 8 hours, depending on the medication measurably in your blood. So what we do at Modern Thyroid Clinic is we check it at the absolute peak. Why? So we can protect people from too much T3. We know inherently they're not walking around all day at this peak, but we can for sure protect them from over medication of T3 if we check it at the highest possible threshold. So for lieth Iranian and site AML, that's like a brand versus generic name. That's about 2 to 3 hours after you take it. For desiccated thyroid armor, ANP run thyroid. That's about 3 to 4 hours after you take it. So and again, we actually want people to peak above our optimal threshold so that they spend adequate amounts of time in it. So to build off of that, imagine if I took my thyroid meds this morning. I'm on a red thyroid inside a mill. It's a Monday when we're recording this episode. Took it on a Monday. Take it in the afternoon as well because all T3 meds should be dosed twice a day. Then Tuesday morning I go and have my labs drawn and I don't take my meds in the morning. Every time my T3 will look low. It doesn't matter if I take ten times the dose today. If I check it tomorrow morning without my meds on board, it will look low. So what happens when you do that? You go to your doctor, you go to your clinician and they say, oh gosh, your T3 slow, let's add more PSI tomorrow. You do that, you go back six months later, you recheck it off meds and it looks slow again. They increase it. That goes on for 510 years and you show up to my office and on meds. Your T3 is above the detectable threshold of 34, for example, because that has happened on you. I in a 64 year old woman. Holy. I'm like, I'm so glad that you didn't have a heart attack or stroke before you came here. And she didn't have it. She didn't have a sub. I know at 64. Yeah, she was absolutely miserable. And I've had an 80 year old patient come to me with a T3 of 14 with the same situation. And again, like 3.6 to 4.2 is what we're looking for. I don't think I've ever seen much over five. Oh yeah. And it's becoming you know, it's becoming kind of an issue more than it normally is. But you have patients that are self-medicating. You know, they are prescribed this to people. Right? Right. So it is so important to check labs on meds. I can't state enough some people wait till it's not peak and it's kind of coming down a little more. And I get that if you standardize your data points and you want to do that, that's fine. I want to be the most cautious. Like, if this is our shtick, I want to be sure that we are doing everything we can to protect people from too much T3 and using it, but using it in a very safe way. I like that, if you had to take favorites, if you had to like, just not even consider a patient, what's your favorite regimen to put people on? So absolutely. So I have it's two part. So number one, if someone comes to me on a high dose of T4, my favorite thing to do is simply add T3 to it. So most people on levothyroxine based meds don't have enough T3 because of half life differentials. And levothyroxine in something like armor or REM, thyroid or AMP. I don't want to switch that patient over because they'll get worse before they get better. Whereas if I just add a little T3, the hormone that they're missing, they can get their life back sooner. So that's probably one of my favorites. And number two, I love desiccated thyroid, so I love red thyroid run thyroid is a new one out on the market. I know it's new and it rvn thyroid and I worked as a consultant with them. Full disclosure I don't anymore, but they have really they had extremely narrow error margins for dosing. Like it's a bit of an issue. It's theoretically an issue for a medicine. It's really oh, now in armor and stuff because of these small. And that ended in 1983. So armor before 1983 was very unstable physical iron, if you like me. Right, right. So that has been solved for a very, very long time. But it's it's medicine is kind of passed down. It's inherited. We've passed that wide still down for generations and medicine and it's largely not true run thyroid just takes that to the next level and is extremely particular and has a almost no margin of error, like 4 to 7%, which is unheard of in that world. So I love desiccated thyroid. I love armor too. I'm hoping, you know, there's some legislation that's coming out where it is supposed to be removed from the market. All desiccated thyroid things on my list. Yeah. The first question I wanted to make. Yeah. In there for my own curiosity. Yeah, yeah. So it's a sad state of affairs. I know it's a little scary. So in August of 2025 last year, we all a lot of us got a letter that said, hey, begin to transition your patients off of desiccated thyroid and move them to synthetic forms. Levothyroxine like with irony, we're removing this from the market. There's a few dynamics happening has been approved, but it's not until a certain date. Right. So it's interesting. So armor has been around. It was the first thyroid medication. It's been around for 100 years, half a century before levothyroxine. So it's been around a very long time. It preceded the FDA approval process. It was around before the FDA existed. So it it has been added into the marketplace, as has desiccated thyroid right now, all desiccated thyroid companies, for the first time in history are in process of receiving FDA approval. So it is a little strange that the FDA decided last August that it's removing them from the market by August of 2026. Very strange right? If they've been around for 100 years. Yeah. So after that notice came out, the leader of the FDA, McCrory, came out on a tweet and said, don't worry, we're going to leave these in the marketplace until people can have an FDA approved alternative, for these meds that has never been formalized. So pharmacies are now stopping carrying armor and NP, insurance is dropping it as of April of 2026, in a lot of cases. So it's getting to be a little scary in the marketplace because nothing formal has ever been retracted. About that statement. Manufacturers are even told to halt production. So little scary for people like me and our patients who are on desiccated thyroid. Luckily, I know the owners of Run Thyroid very, very well. They are continuing on. So right now at Modern Thyroid Clinic, if people can't get armor, we're transitioning them to thyroid and we have what's called the thyroid Health Alliance. You can find us at the Thyroid Health alliance.org. We are starting some initiatives very soon to maintain access. We're starting a Thyroid Freedom Day, in April of this year to advocate with your representatives to keep this on the market. And we have some other initiatives as well. So please go there and sign up. Because we want to protect access to these meds because they are absolutely essential for 4 million plus people. Luckily, I have had my head in the sand about this. And when patients asked me, I'm like, don't worry, it's not going to happen. There's no way, right? And luckily, because they know people like you are out there marching. We're trying. I had to say like, please, McCall, make it happen. Pull this off. Because I don't have nearly as many thyroid patients, but I have plenty. It's scary. Right? And but I want to say, like, ten things. I, I coming out of residency didn't have a dog in the fights and. Right. My returning NP and whatnot, I knew the least about armor, desiccated thyroid in general. But just if you asked me nothing, did I my own, like what my patients prefer the most? It's really. That's okay. Yeah. More patients are happy with their thyroid hormone on the desk. Yeah, and that's not to say everyone needs to be all right. I want to be. Well, I like their synthroid. Right? Yeah. Cool. But it is interesting. Overall, more people like the desiccated regimen. And of course, I'm sure you've had people switch back and forth and, and in the patients that I've seen switch back and forth, more people go back to the desiccated thyroid. So yeah, spoken. Another thing I tell people is like, well, RFK is in office and he's pretty pro most of these things, testosterone included. So I would like to believe that if he's kind of focused on vaccines and whatnot right now. But I would like to believe and I just want to remind myself, is that at the stroke of a pen. August 20th, 2016. Right? Yeah, right. Shut up. Sign it away. I hope some of you know anything about that. He definitely knows. We've texted him. We've sent him messages. He was a little bit aloof to the situation for sure, which is kind of scary and a little bit on invested. I hope that changes. I think there's a lot of things in the marketplace that could shift with shortages and things if something doesn't formally come out soon. So we're working really hard to ensure that that happens. But I really hope that at the end of the day that we can call up RFK and plead for access, I need to think about. I was just thinking like, oh, just August, there's just going to be a hard cutoff not available. But I didn't think about markets. And like they need to pay attention that if they can't sell anything past August, they don't want to be stuck with a bunch of inventory and yeah, or flagged for noncompliance with the FDA, which is obviously scary for them. And I mean, I'm sure you thought the same if we have the source out of the country for our patients, I'll figure it out. Like to, but I had to go for other stuff. And, you know, the thing is, too, it's it's not an easy transition to go from desiccated thyroid to, like, synthroid. Like, if I were Nina, it usually takes a few treatment rounds of like adjustments. And I say that because I struggle with. Yeah. No, it's very difficult job. Okay. Yeah I know it's incredibly difficult. Tell me like what is the next 3 to 6 months okay. If it's Rocky. Yeah. You're getting married or something. Let's just stick with what we got. Amen. Like, and it doesn't matter how how good you are at it. It's a challenging thing because of Half lives and reverse T3 and all of these issues. So, hopefully we get we get a shift in, in the legislation. Yeah. We will, we will. Okay. We've got a few minutes left and paying attention. I want to ask more about autoimmunity because. Yeah. Hardly anything about that. Of course people need to test for Hashimoto's. It's just so obvious. I can't believe people aren't. The two antibodies again are TPO farad peroxidase antibody and thyroid globulin. Please go order them yourself if you're not alone. So tell me. Just rapid fire. Yeah, a couple minutes. Yeah. Autoimmunity. Hashimoto's go. So research shows 80 to 90% of people with hypothyroidism have Hashimoto's. And what Hashimoto's is, is your body gets confused. It thinks that your thyroid is a foreign invader, and it starts to mount an attack on your thyroid, and it sort of erodes away that hormone secreting tissue, replaces it with scarring, inflammatory tissue that naturally doesn't secrete hormones as well. Right. So you're left with a lack of hormone production, which leads to hypothyroidism. Now regular medicines approach to Hashimoto's as well. You have yeah. You have the reverse lottery. Like you've got this thing. There's nothing you can do about it. Don't worry. We never need to check it again because we only need to worry about managing your medication with your thyroid issue, right? Which is not true. So research shows a lot of research. And definitely what we see at Modern Thyroid Clinic, and what you see every day in your practice is we are able to influence these antibodies. You can reduce them and in some cases go into remission. As you reduce your antibodies with your lifestyle, things like a low inflammatory, micronutrient dense diet, exercise, selenium, zinc, you know, kind of sometimes sleep reducing iodine, things like low dose naltrexone and even GLP one weight loss medications reduce Hashimoto's antibodies. So as those antibodies reduce, you preserve more of your thyroid gland, but you also reduce your risk for other autoimmune diseases, right? Because when you have one, you're at an increased risk of over 30%. Yeah. Of developing others. So how amazing if we could mitigate that risk and its objective. This isn't like some fairy tale magical thing. It's check your antibodies on day zero. Make an intervention. Go dairy free, go gluten free. Check them again in 90 days. See how much they've reduced. If they've reduced, continue. If not, pivot. Try something else. But you want to get as much data as you can so that you can see how your body's responding in black and white and, you know, I've seen antibodies drop 500 points in three months, you know, so it's incredibly, incredibly possible. My antibodies used to be over 600 TPO. The threshold for that is like 34. So I mean that's a big drop. And I have had no antibodies over ten for over 12 years now. So I wanted to go back to yeah. Was your body meaning that what worked for your neighbor. That worked for you. Yep. Try whatever. Keep looking keep searching. So I'll reiterate you got to go get your labs virus coming out with a full thyroid tumor. It's going to have all the markers and things. So that's an easy checkbox for them to do. But even any basic lab can can do this. Anybody can control blood can do these. So where can people find you yelling from the rooftops about how do people get get to you? Yeah. So you can find me always that modern thyroid clinic that our practice is nationwide at this point. We started here in Austin, Texas and then got a 9000 person waitlist. So now we're nationwide. So you can I was looking at your website. You have like 20 people on the list. Yeah, 20 practitioners. Yeah. We're we're getting up there for sure. It's busy. You can also find me on social media at, you know, on Instagram at McCormick, Pearson PA or TikTok is kind of my favorite McCormick Pearson. And then I also have a podcast. I'd love to have you on Modern Thyroid and Wellness. So that's kind of a website I missed that. Did you say the website Modern Thyroid clinic.com? No hyphens or anything? No. Yeah. Yeah. And for your time. Thanks for having me. If you're a practitioner interested in exploring advanced biomarkers from vibrant, you can learn more about testing options at Vibrant wellness.com. And if you enjoyed today's episode, be sure to subscribe, share it with a colleague, and follow us on Instagram at Vibrant Wellness. To stay tuned for more conversations on the future of Precision Medicine. See you next time.