Hypo-Thyroidism and its Connection to Metabolic Dysfunction

In this epsiode I'm sitting down with Dr. Kevin Smith, a functional medicine practitioner and founder of the Chronic Conditions Center in Pittsburgh, to discuss hypothyroidism as a “silent epidemic” behind fatigue and weight-loss resistance.

You can learn more about Dr. Kevin Smith at - https://www.metabolicsolutions.net

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Transcript

 Welcome to the 9 to 5 Wellness Podcast, a show about corporate wellness solutions with innovators and forward-thinking leaders who are at the forefront of the workplace wellness movement. I'm your host, Ayesha Tahir. 

Hello, and welcome to this episode of 9to5 Wellness Podcast. Today's episode is on a topic that I know a lot of my patients deal with. It's on a condition that a lot of my patients have, and that is your thyroid gland. So a lot of times my patients and clients are unable to make this connection between, their thyroid gland not functioning properly and how it is sabotaging their metabolism. 

Today on the podcast and LinkedIn Live event, we are talking about hypothyroidism, which in itself is a silent epidemic behind unexplained fatigue and weight loss resistance. So we are gonna take a deep dive into what thyroid gland is, what's happening in this condition that we term hypothyroidism, and for that I have a wonderful guest joining me today. My guest today is Dr. Kevin Smith. He is a functional medicine practitioner and founder of the Chronic Conditions Center in Pittsburgh, PA, Pennsylvania. He specializes in helping people understand and fix the root causes of chronic health problems including gut issues, autoimmunity, chronic pain, thyroid dysfunction, adrenal fatigue, insulin resistance, and inflammation using natural, non-invasive methods. 

Welcome to the show, Kevin. How are you? 

Thank you very much for having me. It's a pleasure to be here today. Awesome. I'm so glad that you can join us today. So I wanna dive right into this topic because I know that a lot of people that I work with are suffering from hypothyroidism and/or maybe it's not hypothyroidism. Maybe it's another condition that's very similar to it, but the symptoms are same. For that reason, I want all of us to understand what hypothyroidism is- And if you can tell us about the thyroid gland a little bit, that would be helpful for my listeners and my viewers. 

Sure. So the thyroid gland is a small butterfly shaped endocrine gland that is located in the front of the neck, right above the little notch where your neck joins your thorax. The thyroid gland produces thyroid hormone, and the function of the thyroid hormone, it's called T4 and T3, is to energize your cells, to make your cells run correctly. And the analogy that I'll use with you, with your listeners, is that the thyroid hormone is kind of analogous to an accelerator pedal in a car. When you step on the gas, the car's gonna speed up, and when you take your foot off the gas, the car's gonna slow down or it's gonna come to a stop. Every single cell in your body has a receptor site for thyroid hormone. That means every cell, all 70 trillion of them, have a ref- a, a receptor site for thyroid hormone, and it needs thyroid hormone in order to provide the energy to make the cell run. So if it's the neurons in the brain, they rely on thyroid hormone. If it's the gut, or the cells of the gut, they also have a reliance on thyroid hormone. The heart, the lungs, the pancreas, the, the spleen, like literally everything in your body needs a sufficient amount of thyroid hormone. And if you don't have enough thyroid hormone, either because you're not making enough, or you're not transporting it correctly throughout the body, or it's not converting correctly into the right type of thyroid hormone, then the result is that you're gonna have things like fatigue or tiredness. You're gonna have problems falling asleep or staying asleep. You could have a problem with your hair falling out in clumps in the sink, or the loss of the outer one-third of the eyebrows, or the nail beds in your fingers or your toes get weak and cracked. You could have fertility problems that result in inability to conceive a baby, or a problem with the menstrual cycle. Problems with, bowel transit times that can result in, constipation or diarrhea or malabsorption. Ca- problems with your heart, either causing, , your heart to slow down or to speed up or to, palpate, , abnormally. So literally every single part of the body can be affected By a problem with thyroid. In our case, 97% of all cases is hypothyroidism, meaning it's too low. Maybe 3% is due to high levels of thyroid, but it's very rare compared to hypothyroidism. Got it. Thank you so much for explaining the thyroid gland, its function, and then what hypothyroidism . Yeah. Is. , Something that you just mentioned , that I do notice, like, one of the symptoms that my patients come to me with, and they feel a little lost, is that they are tired and fatigued. Like, continuously. Like, it's something that they can't have, like, a good night's sleep, and then they're feeling better, right? Because a lot of times we are... I mean, we do a lot. We, we, we have a lot on our plates. That is true in our modern life, but it's something that they just can't shake off no matter what they do as far as sleep and rest is concerned. They're continuously tired, and they oftentimes come to me and tell me, " We feel like something is off," you know? Like, "We just don't know. We can't pinpoint it, but something is just off." So what are the top subtle signs of hypothyroid - thyroidism that you see with your patients which you might feel like are often ignored or misdiagnosed? Well, like you pointed out, one of the biggest ones is fatigue or low energy or, , if you feel like you just are too pooped to go, you... it can wreck your, your entire day. You can't, you can't work. You can't play. You can't maintain your property. It's a really, really big deal for a lot of people, and what I do is I look for the hidden root causes of what causes that hap- to happen in the first place. N- in my opinion, nothing happens just because. There's always a root. There's always a reason why something is amiss, and so my job, as I see it, is to look for those problems and correct them, whether it's, a nutritional deficiency or, you're not getting enough sleep, and why is that? What's going on? I'm about... I'm not about, , just chasing down symptoms. I'm looking at what's driving the symptoms in the first place. So let's talk about, the root causes then, because I know that we did, , touch a little bit on the symptoms as you were explaining the function of the thyroid, right? Yeah. That it can impact your hair growth, texture of your hair, fertility issues, , and then same with your gut issues, right? If you're going regularly or not. So then what are the root causes that we are looking at? It depends on where you're located. In, in the United States, the number one cause of hypothyroidism is Hashimoto's disease, and, , that's about... it accounts for about nine out of 10 people that have low thyroid issues. Hashimoto's disease is not an endocrine problem, it's an immune system problem. So your white blood cells, your de- body's defense mechanism circulates throughout the body and starts mistakenly attacking and destroying your thyroid gland. An autoimmune disease is kind of like a schoolyard bully. If he's picking on kids over here, he's probably also picking on k- on kids elsewhere. So it's very common to have problems with their thyroid gland, with the brain, with the gut, with the skin, multiple areas of involvement. Now, the one thing that's really important to say about , autoimmune disease is that it cannot be cured. Anybody that ever tells you that they can cure an autoimmune disease is lying to you. Now, while you can't cure an autoimmune disease, you can make it dormant so that it's no longer causing misery in your life. It's, the... a light switch. You can't just shut it off, but you can dim it down so that it's subclinical, and that's the best goal That we can have for these problems. Autoimmune disease is very mysterious. Just, , there's about over 100 different autoimmune diseases that have been identified by researchers, and it all depends on what part of the body is being affected. If it's the th- if it's attacking your thyroid gland, that's called Hashimoto's disease. If it's, uh, if it's attacking the synovial joints in your hands or in your spine, that's called rheumatoid arthritis. If it's attacking the brain, that's called multiple sclerosis. If it's attacking the gut, the large intestine, that's called Crohn's disease. If it's the small intestine, it's celiac disease. So the, it all depends on what's being affected. And so if it's the thyroid gland, that's the number one thing in the United States that, that results in hypothyroidism. They think about your little white blood cells attacking and destroying the follicles on the white, on the thyroid gland, and the result is low energy or hair loss or bowel problems or all kinds of things. Outside of the United States, the number one cause for this is iodine deficiency. We don't have that problem in the States because we put iodized salt on everything. We put it in our food, the prepared foods that are made for us. Everything is heavily salted, and as a result of that, we don't have a deficiency. But in , locations like South America or Africa or Asia, it's iodine deficiency. In the United States, it's Hashimoto's. Got it. That's a great distinction that you made. , So I do wanna clarify something. I understand that Hashimoto's disease is an autoimmune dysfunction- Yeah ... autoimmune disease, and I like that you mentioned that it's not necessarily curable. It's a chronic disease. But yes, can we get better management of the disease for the patient where it goes down to the subclinical levels and that's the goal? So in your clinical experience, - you see h- all the patients who are coming to you who have hypothyroidism, it's actually Hashimoto's disease or do you have, like, a split or a percentage of patients who actually have Hashimoto's? Well, 90%, of the time it's Ha- They have Hashimoto's disease. That's the mechanism that's driving the problem. If it's not Hashimoto's, I look at what are called triggers. These are things that can disrupt your thyroid function and cause problems in your life. These are problems like anemias, which is a problem transporting oxygen on your red blood cells. It's not always due to an iron deficiency. It could be due to another problem where the red blood cells are out of shape or they're misshapen or there's other problems like thalassemia. There's blood sugar issues. That's the number one stressor in the body. And that can cause problems either because of insulin resistance, prediabetes, diabetes, things like that. There is cortisol issues, which is part of it's your stress gland. It's your stress hormone, I should say. It's produced by the adrenal glands. It affects the brain and it causes belly fat production and it causes brain fog. There is the sex hormone problems. I'm talking about estrogen, progesterone, testosterone, all the different metabolites of those. Remember, boys and girls make both and they have to be in the right amount and the right balance for your gender and for your age. So, for example, a 58-year-old man is going to have a different profile than a childbearing woman that's maybe 25 years old. There is, I look for things like chronic inflammation, oxidative stress, gut problems, food sensitivities, chemical sensitivities, stealth infections. All of that stuff, all of it has the potential to unregulate your thyroid function. And the problem is that most of that stuff is not being looked at by medical doctors, whether it's an endocrinologist or it's a family physician. They're not going to look at all that stuff. And as a result, they're going to be missing a big picture of what could be causing this problem in the first place. The medical way is just to give you a pill and a very, very small amount of blood tests and send you on your way and hope for the best. And my way is to really look at all the different aspects of the thyroid physiology, the whole entire mechanism, and look at the whole entire metabolic landscape and look at where the problem exists, where there's a breakdown and address it at that point. I love this, Kevin. I love that you are taking the holistic view. Like, all the systems that you discussed, all the hormonal functions that you discussed that you're looking at, those are so important because, again, I, I think every disease presents differently in every patient, too, one patient with hypothyroidism might have thinning hair, as a symptom might have difficulty losing weight, but some patients might not have those symptoms. For some, it might just be gut issues, right? Or hormonal, as you said, sexual hormonal imbalances, based on where they are in their life cycle, a- as you mentioned, which was really good, I wanna highlight it, that the profile that a male patient, 58 years would have as far as all the sex hormones are concerned, estrogen, progesterone, testosterone, and they all exist in women and men in different, quantities, , is gonna be very different than a female of reproductive years. So, , I have a question for you. I love that you're taking the big picture, but what blood tests, tell the story? What, , blood tests actually diagnose hypothyroidism? The first thing I want to mention is that there's no one test that can answer 100% of all the questions out there. The way that I identify these triggers that I mentioned before is to do, testing. The tests come in the form of blood, urine, stool, and saliva. And so by taking a sample of your body, some body part, I can get objective data , and map out where you are and compare that to normal, and we can show you this is out of order, this is out of order, we need to get this back in order. And so we can... It's not based on guesswork. It's based on objective laboratory, uh, testing. And so we start off g- general. We start off by doing a foundational Blood and urine evaluation. And we look at things like how your kidneys and liver are functioning, how are you making vitamin D, how's your blood lipid profiles. Those are the things like your cholesterols. , How is your iron cycle doing? Are you, are, do you have, suffer fro- from an anemia? We do a CBC with a differential, that's a complete blood count, looking at your white blood cells and your red blood cells. We look at, your, if you have any kind of inflammatory markers that could possibly be related to what's going on. But something that you mentioned earlier is important to make note. No one, no two people have exactly the same exact profile. One person, they may have low energy. Another person may have a problem with their sex hormones and have problems with their menses or conceiving a baby. Another person may suffer from chronic, , constipation issues. And so by doing this approach, we can identify really what's going on behind the scenes, what is driving the mechanism, and so we can put an end to it. But to answer that first question, we want to start off by doing some foundational lab tests, and then branch off from there depending on what direction we have to take it. Thank you. Thanks for really explaining all of this, because I love how you're, looking at the pathophysiology of different systems and through different routes, not just blood tests. You said y- there are other things, too, that you're doing, like stool testing, urine testing, right? Because all of that tell a story, like, the, just to dive deeper into it. And I love how you're looking at the lipid panel and, insulin resistance as well. I wanna expand a little bit more on anemia that you did mention earlier, . How is that connected to hypothyroidism? So anemia patterns is... the short answer is, it controls how well you're de- able to deliver oxygen throughout the body. Uh, oxygen binds to the heme molecules on the hemoglobin, and they transport oxygen to different parts of the body. Every single cell in your body, every one, needs oxygen for s- normal survival. So if you cut off the blood supply, and with that the oxygen supply, you're gonna experience a medical problem. Do you remember when you were a kid and you used to wrap a rubber band or a string around your finger it turn, till it turned purple, right? Right? Everybody does that. Why did it hurt so much? It hurt because your brain says, "Don't do that. That's not a good idea," right? But as soon as you take the string off or the rubber band or something blocking that, that limb, the circulation is restored, the pain goes away, it starts to turn a normal color. So that's what happens with, with the skeletal muscle. If you cut off the blood supply and with that the oxygen supply to your brain, that's called a stroke. If you cut off the oxygen supply, and with that the blood supply and the oxygen to the heart tissue itself, that's called a heart attack. So every single cell is gonna suffer if you don't have a sufficient amount of oxygen to that particular area. When you have a chronic issue where the, , you have an insufficient amount of oxygen being circulated throughout your body, it's called anemia, and that leads to a problem called mitochondrial uncoupling, where the mitochondria, this, the part of your cells that makes energy, is compromised. And, , it's a bad thing. It can cause all kinds of health issues. In the case of the thyroid gland, it can cause you to have hypothyroidism. It's one of the major triggers that we look for. So we'll look at things like your hemoglobin, your, the shape of the red blood cells, the size of the red blood cells, how much iron is bound to them, your capacity for binding oc, iron to those cells. And if any part of that is compromised, that can potentially cause a problem with your thyroid gland. Thank you for explaining this. And I do wanna highlight how you mentioned that it actually impacts your mitochondrial cells or mitochondria within the cells. Yes. And those are your energy powerhouses. So any hormonal dysfunction or anything that would impact your mitochondria is gonna lead you to have, fatigue, that fatigued feeling, which is very common, with patients who suffer hypothyroidism or just continuously being tired. Like, you can do nothing to get rid of that feeling. , That is exactly what's happening, and the underlying cause is mitochondria. There's something going on with your mitochondria and- I love how you explain the pathway of, anemia, and then how it, , actually also, ties into the hypothyroidism. I have a couple of questions now that I do wanna expand on, but the first one is the lab testing, because we did talk about all the labs that you're looking at, and I think that's a great idea. But as far as thyroid function is concerned and the hormone that we are looking for is concerned, what is the blood test that we are looking at? I know it's called TSH blood test. What are we looking at? So it depends on what kind of a doctor that you're going to. If you go to a family doctor, primary care physician, endocrinology, they will order one or maybe two tests. They're gonna order a test called a TSH that stands for thyroid stimulating hormone. That's a panel that you... It's a blood test, and it measures , your, , pituitary gland's effectiveness to secrete, the hormone TSH that affects the thyroid gland, that makes it produce T4 and T3. And then maybe if you ask nicely, they'll a- they'll order a T, a free T3. That's about it. When I order thyroid tests, I order 9 or 10 different tests. So I'm gonna order a TSH, a free T, a total T4, a free T4, a total T3, a free T3, T3 uptake, reverse T3, TPO enzymes, and anti-thyroglobulin enzymes, because that g- is gonna tell me a story about how the entire mechanism is working. Medical doctors know this. They're taught this during medical school, but they don't do it. They don't do it regularly because they are, their hands are tied by insurance companies. Insurance companies just wanna do the very bare minimum that they can get away with without being sued. When a medical doctor, like your family doctor, orders a bl- a lab test, they're gonna order just enough tests to arrive at a diagnosis in order to justify prescribing a drug And that's what you're gonna get. That's the whole entire deal. They're gonna order maybe 10 or 15 different biomarkers on their tests. When I order tests, I'll look at 63 to 100 different biomarkers, and so it's a lot more comprehensive of an analysis because I'm gonna see the entire metabolic pathway and how everything is linked together. And that is, , that also includes a urinalysis to look at kidney function and how your pro- how you're filtering your blood and all that business. But that's just the, that's just the starting point. After that we'll look at, the microbiome or the way that your gut is making bacteria to help process your food. How's, your absorption? Do you have any inflammation in your gut? Is there any occult blood in the gut? Is there any bacteria, , what do you call it, antibiotic-resistant strains? What, what's going on with that? Collectively, I would say that about 95% of your, of, hypothyroidism is related to lifestyle and your profile, and 5% is related to genetics. So some people may be wondering, what if it's a genetic problem? That is entirely possible, but 95% of it is probably related to your lifestyle. I absolutely agree, and I tell my patients when they come in and they're blaming their genes and, "Oh, my mom had it," you know? Yeah. "My mom had it." So, you know, there was... I had no escaping it. I tell them, 'You can overcome your genetics with your lifestyle.' Yeah. There, there are some problems that are linked to genetics. , Certain types of cancers are linked, but if you focus on lifestyle modification and cleaning up your, the fundamentals that you need to do to keep everything working in good order, most of the chronic conditions will go away. Yeah. Absolutely. , Before we dive into the lifestyle modifications, and I do wanna talk to you about those in detail, , what are the pharmacological therapies that we are looking at as far as hypothyroidism and Hashimoto's is concerned? When it comes to hypothyroidism in general, people are gonna be given a thyroid replacement hormone. A, thi- something like Synthroid or levothyroxine, Cytomel, things like that. According to research, 17% of people that suffer with low thyroid disease are gonna be helped by those medications. That means 87% are not gonna be helped. They're not gonna be helped at all. So you take Synthroid, uh, maybe you start off at, like, 50 micrograms per day, and then they bump it up to 88 micrograms per day, and then 100 micrograms, then 120, then 150. And they just keep raising it over and over and over again. But eventually, you don't have any result from this even working, and that's because the, the thyroid replacement hormone does not affect at all if it's related to Hashimoto's. Again, Hashimoto's is not an endocrine problem. It's an immune system issue. So by taking hormone replacement therapy, that's like having an electric problem and hiring a plumber to fix it. It's the wrong guy for the job. I love that analogy. I love it. Yes. Okay. , The treatment mostly given to the patients, and that's what is given, sadly, because we are not all looking at those detailed labs, as you said. I mean, that's not covered by insurance, and I think, And I do wanna highlight it over here, what you just said. We are still living in a culture and society where we are dependent on, we as patients, consumers of healthcare, are still dependent on insurance, and I talk to a lot of patients, and they're not willing to make that investment to find out something beyond the basics. That be- being said, I totally understand how the medical system works and, it's gonna be the bare minimum testing, and then we are gonna, , prescribe the medication based off of that test. Can you discuss the pros and cons of using T4-only medications? Because I've seen a lot of my patients on only T4 medications versus combined T3, T4 therapy. Well, there's a lot of stuff to unpack right there. , The first of all, I, I do wanna agree with you that we live in a drug culture, and, , the, we have drug ads on TV all the time convincing us to buy their products so we can hear, "Talk to your doctor to see if blankety blank drug is right for you," right? That's all I get, while I'm watching, basketball, It doesn't, it doesn't matter- ... or championships ... what you're watching, it doesn't matter what time of the day or what network you're watching or what channel, you're always gonna be pummeled with drug ads. They spend about $12 billion a month to consumers- Wow ... to get you to buy their drugs. There's a very good reason for that. Now, , it's not necessary for most people to do drugs, to , take drugs. I'm not anti-drug, I'm not anti-doctor. I believe that there's a time and a place for all healing, including chiropractic care, including medicines, including surgery, including physical therapy, acupuncture, functional medicine, everything. But I also believe that we as a people are overmedicated, so I wanna give people a different reality and educate them about , what they're actually getting. They may think that they're dependent on medications or on insurance, but in reality, it's not really necessary. For example, if you need a new roof on your house, you're gonna have to pay for it. The insurance is not gonna pay for, your roof gradually wearing out over 20 or 30 years, and then getting a roofing company and getting it corrected. Same thing with your furnace or your air conditioning. If that goes out, that's an investment in your comfort. Same thing if you, , if your car doesn't work anymore, either you pay the bank or you pay the mechanic, otherwise you're gonna have to pay something, somebody. , But , people will be happy to pay for things that make sense to them, that is gonna im- improve their life in some measurable way. My prices are very reasonable, it's still very affordable, and what I do is I, I find a way to just cut out the middleman. I cut out the insurance company, because I... They c- they can get that, and they should try that. But if that's not working, it's not gonna work in the future, and then we can try something different. You asked a question a while ago and I don't remember what it was. Could you remind me? Oh, no. That's okay. The question was that, if you could , dive into the pros and cons of using T4 only- Okay, pharmacological, therapy- versus combined T3, T4 therapy. So your thyroid gland makes two different types of hormone. Actually, three if you consider calcitonin. But T4 is the most predominant- Type of hormone produced by the thyroid gland. Probably about 93% of all hormone coming out of the thyroid gland is T4. T3 is only about 7% of all the thyroid gland, all the hormone coming out of your thyroid gland. T3, however, is the active form of, of hormone that your body needs to energize your cells. So if only, if only 7% is coming out, of that is coming out of your thyroid gland, your body needs to recapture T3 from T4, and that is a process called conversion. So it, it basically... Uh, T4 is named because it has four iodine molecules attached to it. T3 is named because it has three iodine molecules. I know, it's rocket science, right? But, um, how your body converts T4 into T3 is to snip off one of those iodine molecules, and it becomes T3, and that happens in the liver, and then it happens in your gut. So you have to have a healthy gut and a healthy liver for that process to work correctly. Sometimes people will take a T3-only supplement or a T4/T3 supplement, and sometimes they'll take a T4-only supplement. Medical doctors, most of them just prescribe T4. That's what's in, uh, Cytomel- and that's what's in levothyroxine. Yeah. Did I say Cytomel? Synthroid. Synthroid and levothyroxine. Yes. Whereas a Cytomel is T3 and T4. So some of them are more hip to the problem with conversion issues. If they have a sick liver, if they have a sick gut, they're not gonna be able to convert T4 into T3 as efficiently. Yeah. And as a result, sometimes they will get better results by taking, , a T4/T3 combination. , Under conversion or over conversion is a serious problem, and it has to be accounted for. And, , I'm not really a big advocate of taking thyroid replacement hormone at all if we can c- if we can fix the problem at its source through a non-drug method. And so- Yeah ... that's the reason why all of them, all of it exists Okay. So there are two questions, and I know that these are towards the tail end of our interview, and I know that's exactly why people are listening to this interview. So let's dive into to the first one, because we have been kind of like playing around with it here. Lifestyle interventions. What are those interventions that your patients, that you recommend to your patients which can help them with hypothyroidism? Well, the first part is nutrition. Making sure that you're focusing on lean meats, fruits and vegetables, and you're not consuming, , highly processed or highly sugary foods or deep-fried foods. That's gonna solve a couple problems right there. It's gonna make sure that you're putting high quality nutrients into your body while reducing your level of chronic inflammation. Chronic inflammation is the root cause of a lot of disease processes that we know about, such as atherosclerosis or heart disease, things that cause heart attack and stroke, and also cancer, diabetes, COPD , or pulmonary problems. All of that is rooted in chronic inflammation, so anything that you can do to reduce your inflammatory markers is gonna be good for you. That's part one. So Kevin, I'm gonna pause you right here, because I'm gonna pretend to be your patient, okay? Sure. Because this is what I'm hearing in my clinical setting. "Dr. Smith, that all sounds great, but I mean, I'm on the road three days a week, and I have four kids at home who I also have to take care of, so most nights it's that oily, greasy pizza at home, and when I'm on the road, I am eating out with my colleagues, and I have very little control over what I eat." Well, I would say , that y- first of all, becoming aware is the first step. Teaching people that eating, relying on Tostitos pizza rolls made in a microwave oven is not the best choice for you o- over, over a long time. , They don't make it convenient. , Every time you drive down the street, you see all these places with a drive-through that makes it very easy to order fast food or heavily processed foods. So meal prep, meal planning organization, that has to come i- a- as a factor. So when people tell me that they don't have five minutes to prepare healthy food, I look at them , I can't help you then. You're clearly not the right patient for me." , I try to give people mechanisms and tactics and strategies and all kinds of different things. Getting a, a autoimmune paleo cookbook or some kind of a thing that can give you ideas to make, and preparing that on your day off, making... say you go and make a whole package of chicken breast filets and you grill all of them, and you put them in Tupperware containers. There's your food for the rest of the day, the rest of the week. Or make y- maybe prepare salad stuff so you can... All, you have all these raw materials, and you can put them together in, in Tupperware containers and, and prepare ahead of time, not waiting until the last possible minute. So I tell people, like, if it's 10 minutes to noon and you're thinking about at that point what to get for lunch, you're already lost. You should be thinking about what you're gonna eat on Wednesday on Sundays. Just if you were the nutrition guy on a cruise ship, he knows exactly what he's gonna serve for people, on Wednesday or Thursday for lunch, for dinner, all that stuff. So they can do that too. That's amazing. That's great. Thank you so much for actually, explaining that and giving really good tips. And I agree with you. That's what I say. You have to make some time for meal planning. Yeah. Because if you don't plan your meals, then you're gonna reach for the easiest, and mostly that ends up being the unhealthiest choice. Right. Right. Right? So what- So, so meal, meal planning and meal preparation- Yeah. Yeah ... are very, very critically important so that you have the raw materials available to very quickly th- throw some stuff together, and all of that comes from... That can really dictate what you're shopping for. , If you prepare your meals ahead of time, make a little grid and, like breakfast, lunch, and dinner. What are you gonna eat on Thursday for dinner? What are you gonna eat on Friday for lunch? That way , you can shop for those raw materials on your day off, and you can be prepared, and it'll also decrease your grocery bill probably. Absolutely. Absolutely. A lot of people, , including my friends, and sometimes even my family members, they're like, " well, you know what? It's really hard to eat," or, "It's expensive to eat healthy." I would challenge them and I say, "No, you have to try it out. It actually saves you a lot of money, because all that processed food out in the grocery stores, that's what's costing you a lot of money." Right. Right. Like- I, I agree. I agree with you like , fruit juices, which are totally sugar. I'm like, " why are you just buying that? You can drink water from home. Put a lemon or lime in it if you are really... if you want taste," right? , Another thing that I wanna add on to the tips that you just... nutritional tips that you gave me, because a lot of my patients are C-suite executives, and they are traveling a lot. And I tell them, the good thing that is coming out of discussing everything like this and then also talking about lifestyle interventions, especially nutrition, is that all the restaurants you go to now, they have healthier menu options. You can customize anything that you're gonna order. I agree. I think that, like, if you go to a restaurant, and you... the server comes up to your table, and if you say, "Look, I'm on a medically restricted diet. Can you work with me?" I found that those people are gonna bend over backwards to help you, and they get it. They really do. But understanding what is good and what is bad has to be the first part. So you don't have to order a Pepsi. You don't have to drink a Diet Coke. You could just drink water. And, , even if you're preparing your me- meals, let's say that you have a road trip and you have to be in another state, and you have a couple hundred miles. As opposed to stopping at the McDonald's at the rest stop, you can pack your own lunch, and you can prepare exactly what's in it. It's not that difficult. It just requires a little bit of homework, understanding what to eat and what to reach for, and then you can go from there. , But I was also gonna say the next step is hydration, making sure that you're r- you're drinking plenty of fluids to make sure that your kidneys and your liver are working right, and your blood is nice and thin. And that just comes from drinking plenty of filtered water. , I live in Pittsburgh and, .. a plumber friend of mine was educating me about , the ways that the water treatment places are cleaning up the water. , They're using a chemical called chloramine, which is a cheaper version , than the old-fashioned stuff, which is straight up chlorine. Okay. And everything is economical, e- it's economics driven. They don't care about your health. They just want to give you , the very bare minimum so they don't get sued. That's it. Yeah. Would you just suggest to our listeners, viewers, and your patients, to buy, like, filtered water or have, like, a filtration system at home? Well, I think that buying bottled water is probably the most expensive way to do it. But if you have, like, a filtration system, a reverse filtration system, there's all kinds of things that you, your viewers, your listeners can educate themselves on different technologies and different techniques. I think that just... When I was a kid, we drank out of the hose, but that's not really a reality now because the water is a lot less pure than it was back then because they're- Yes ... they're just, they're- All the toxins ... all the toxins. Environmental toxins. Yeah. It's bad. But, , as far as the other types of suggestions, you have to get plenty of sleep. That goes into people that have problems falling asleep or staying asleep, or they're over consuming blue light by looking at their phone too much, or they're watching TV until it's late at night. There's a certain type of a protocol that I teach people to prepare for bed, whether it's drinking chamomile tea, or taking a bath, or reading a book, or s- setting the temperature correctly so you're comfortable, maybe a little bit cool. , All that stuff is , very important so that you can get between six to nine hours of restful, replenishing sleep, so you can recharge your battery, , your brain the next day, so you can be at your very best the next day. I also talk about getting about three to five episodes of exercise per week so that you are... it regulates your hormones, it regulates your mood. It helps you to get rid of extra sugar molecules that are stored in the skeletal muscles. And so , you gotta exercise, whether it's just going for a walk with your dog, or going to the gym, or just- Just doing something. Just get outside and play like you did back when you were a kid. Yes. That's the normal default mechanism of people. The normal default mechanism of people is not to just mindlessly scroll on your phone for eight to 10 hours a day. That's not normal. Yeah, that's what we are doing now. Yeah. Or for kids to be on the Xbox playing the games all day. Right. Exactly. Yeah. I mean, the- kids don't go out to play, feel for- I, I grew up, I grew up in the 1970s, and it was a whole different world back then. You came inside when the streetlight came on. You didn't have organized play dates with the helicopter parents hovering nearby and all that business. Um, but I also talk about things like managing your stress correctly, managing your stress through meditation or journaling, or just r- m- doing a mind dump, or writing down everything in your mind on paper, and , it's cathartic. It feels good, and you can get rid of a lot of stress that way. And I also talk about- I love these ... I also talk about, , maintaining your, your frame, maintaining your body, your joints, and your posture through chiropractic care. , Very important. It's a , very overlooked area that is part of , the overall wellness mechanism. . I agree. All of these are wonderful tips. Okay, so I wanna wrap this up with a couple of things, because I know that our viewers and listeners are probably, , looking into it, and they're, like, waiting for that. What is the connection of hypothyroidism or Hashimoto's, and I know we touched upon it indirectly a little bit, but I want us to leave with this very strong connection to metabolic dysfunction, because a lot of these patients are suffering from, the,, weight loss resistance. So what is the connection there with, weight gain? With weight gain, I would say that it's probably due to insulin resistance, and it's due to hormonal issues. There are four hormones that regulate your body's s- uh, set point, or your... It's like a thermostat on the wall. If you set the thermostat to 68 degrees, the air conditioner will kick on until it reaches 68 degrees, or the heater until it rises to that level, and then it will shut itself off. And that's why it's so difficult to lose weight or to gain weight, because the four hormones have to be accounted for and controlled. Those are things like insulin, cortisol, ghrelin, and leptin. And, and we have to design a plan that can control those hormones, and then the pounds can come off, and you can have more energy for work and for play. Sounds great. Sounds great. Okay. So Kevin, I know that a lot of my listeners probably resonated with whate- uh, what the, the information you shared. You are a wealth of knowledge. Thank you. Thank you for sharing all of this. Where can our listeners and viewers find you? So the easiest way to find me is go, going to my website, which is metabolicsolutions.net. And in metabolicsolutions.net, I have a free two-minute metabolic health assessment that you can do, and it takes about two minutes of your time, and it'll score where you're at, and then the results will be sent to you immediately via email. So when you go to metabolicsolutions.net, you're gonna see a couple of drop-downs from the menu bar. One of them is the free two-minute metabolic assessment. Do that and, and you'll get really good information about where you're at and what's going on and how severe are these problems. It's not a diagnostic, it's just a, a place to start looking. Oh, that sounds great, and that would give probably a little bit more insight to the patients a- and listeners to understand where they stand, right? And I'll include that in the show notes. You said metabolic? Metabolicsolutions.net. Metabolicsolutions.net. I will include that. If you go to metabolicsolutions.com, it w- it's not... It's somebody else. So go to metabolicsolutions.net and then look for a couple of drop-downs from the menu bar. You'll see the free health, metabolic health assessment. Takes two minutes. It's completely free, and you'll find out what's going on and how severe your problem is. Is it mild? Is it moderate? Is it severe? And what to do about it at that point. Awesome. Sounds good. Any parting words, Kevin? No, I just wanna say it's been a pleasure. I thank you very much for having me on your show, and I hope that, , I was able to add some value to the lives of your listeners. You absolutely were. Yes. This was great. We dived really deep into hypothyroidism. We could create all those connections to other systems within the body, and then also I think a lot of, , people do not understand the connection to Hashimoto's or Hashimoto's being the root cause that is actually wreaking a havoc on their thyroid gland. So thank you for explaining all of this. This was super helpful. I learned a few new things, too, and that's actually why I host this show because I'm like, I'm always curious about all these topics. And your lifestyle interventions, I have to tell you, right on point. Those are the five areas of our life. If we can all focus on getting a little bit better every day in those departments, let's just say of life, I know that we will have better health. So thank you. Thank you for sharing all those tips. And thanks for being on the show. And thank you everyone for listening to us, and if you watched this interview live, thank you for joining us live. I'll see you guys soon next week. Bye for now. If you like this show today, please share it with your friends and family members, and don't forget to subscribe to our show so that you can get fresh episodes every week.