What Does "Anti-Inflammatory" Actually Mean for Hashimoto's?

Beyond the Thyroid - Episode 50: What Does Anti-Inflammatory Actually Mean for Hashimoto's?

You've heard it everywhere — eat anti-inflammatory. Avoid gluten. Follow an anti-inflammatory diet. But what does that actually mean for someone with Hashimoto's disease? And more importantly — is the inflammation you're dealing with even the kind that diet can fix?

In this episode of Beyond the Thyroid, Dr. Dana Gibbs continues the series on food and Hashimoto's by breaking down the two distinct drivers of inflammation and explaining why they require completely different approaches.

She also challenges the way most patients approach food changes: starting with restriction before nourishment, which often backfires — especially when you're exhausted.

In this episode you'll learn:

• What patients actually mean by 'inflamed' and the physiology behind it
• The difference between metabolic inflammation and immune-driven inflammation
• How to use a standard lipid panel to assess whether insulin resistance is driving your symptoms
•  Why the Mediterranean diet is the most evidence-backed starting point and how to adjust it for your metabolic picture
• Simple, low-friction food changes you can make right now, including a make-ahead savory breakfast that stabilizes blood sugar all morning
• Why nourishment before restriction changes everything and why the order matters

Dr. Gibbs also introduces a practical two-sentence framework for getting started — designed specifically for patients who are too exhausted to overhaul their entire diet at once.

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Episode Highlights

00:00 Welcome
00:45 What Patients Mean by Inflamed
03:39 Inflammation Labs Explained
04:27 Ferritin Low vs High
07:01 Metabolic Inflammation Basics
09:02 Insulin Resistance Symptoms
10:32 Triglyceride HDL Ratio
12:45 Mediterranean Diet Foundation
17:40 Simple Breakfast Upgrades
19:56 Fiber and Fruit Choices
21:11 Healthy Fats and Yogurt
23:38 Smart Substitutions
25:12 Breaking Sugar Cravings
28:51 Why Add Before Eliminate
30:53 Wrap Up and Next Episode
32:04 Resources and Outro

This episode is part of the series 'I Have Hashimoto's: Do I Really Need to Eliminate Gluten and Dairy?' — continuing from Episode 49's overview of food sensitivities and elimination diets. 

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✉️ Email Dr. Gibbs at drgibbs@DanaGibbsMD.com or visit https://www.danagibbsmd.com/ for more information.


Thank you so much for listening! Tune in on the next episode.


The medical information provided in this episode is intended for informational purposes only and should not be construed as medical advice. Always consult a qualified healthcare provider regarding any medical questions or concerns.

Transcript

dana-gibbs-md_2_05-11-2026_195215 0:00

Hello, my friends, and welcome back to Beyond the Thyroid. If you are new here, welcome. I am so happy you're here. I am Dana Gibbs, MD. I'm a thyroid specialist, former thyroid surgeon, and a patient myself. So this is part two in a planned six-part series about Hashimoto's disease, gluten elimination, broader elimination diets, and the debate about the need for gluten-free eating in particular. Today, we're gonna talk about what it actually means to eat in a way that reduces inflammation, not in the wellness influencer sense of that phrase, but in a way that's grounded in physiology and genuinely useful for people with Hashimoto's disease. And I want to start not with a textbook definition but with something that I feel you'll notice to be very familiar. So if you spend any time in online communities for people with Hashimoto's, and a lot of my patients do, you will see a word that comes up constantly. The word is inflamed or inflammation. Patients describe this as their central problem. They say they feel inflamed. They're trying to reduce their inflammation, and they believe that certain foods are causing inflammation, and they want to fix it. But what's interesting is that when you read through what patients are actually meaning when they use these words, the descriptions are very consistent and almost the same across the board. These people are not talking about a lab value. They're talking about a felt sense, a whole body state that's really real and really distressing. They often describe puffiness of their face, their hands, their abdomen, rings that don't fit, joint stiffness that's worst in the morning, a heaviness or a slowness that's hard to articulate, brain fog lagging thoughts, difficulty concentration, losing words mid-sentence, and a sense that their thinking is moving through something thick. And fatigue that's not like ordinary tiredness. It doesn't lift with sleep, and it feels almost toxic. And then there's this loss of predictability because they feel different from one day or one week to the next and can't explain really why. And that unpredictability adds its own source of distress because it makes it really difficult to commit to things, to plan, and to trust that you'll be able to show up for your own life. So when patients start to feel better, they describe that just as consistently. They don't say, "My CRP went down." They say, "I feel less inflamed." And what they mean is their rings fit again, their face is less puffy, their brain feels clearer, their energy is more even. And it's not this one symptom at a time disappearing, it's this return, boom, to feeling like themselves. And that's what we're working towards here. So I take it very seriously when the patient across from me tells me they feel inflamed, but I don't assume it's coming from a single source, and I certainly don't assume that it's coming from gluten. And I don't assume that the solution is automatically that they must remove a certain food or a certain set of foods, because what they're describing is often the result of several physiologic processes, and all of them are experienced in basically the same way. So let's talk a little bit about what those processes are. From a medical standpoint, we do have some tools that begin to measure inflammation, and although none of them is perfect, this is an area where clinical pattern recognition really matters as much as any single lab value. So the most commonly used marker we have is something called C-reactive protein or CRP. This reflects a generalized state of systemic inflammation or inflammatory activity. When the immune system is significantly activated, your CRP number will begin to rise. It's useful, but it's not specific. A normal CRP doesn't mean there's no inflammation happening. It just means that the type of inflammation CRP captures is not elevated at that moment. Ferritin is another marker, although it's less common, that comes up in this context, and I really do want to take a moment here because it is genuinely confusing. So ferritin is an iron storage protein, and when it's low, it tells us something completely different from when it's elevated, and this distinction matters a lot in Hashimoto's patients. A low ferritin is a sign of iron deficiency and even though the reference range goes all the way down to 13 in some lab panels, if you're suffering from Hashimoto's disease and your ferritin is below 30, that's probably significant for inadequate iron levels because- Iron plays a critical role in thyroid function specifically. It is required for thyroid peroxidase activity. Thyroid peroxidase drives thyroid hormone production. It's also required for the conversion of T4 to T3, which is the active form of thyroid hormone, and it's essential for basic mitochondrial energy production in every cell of your body. So when ferritin is low, patients will have profound fatigue, brain fog, hair loss, shortness of breath on exertion, even when their thyroid labs look normal. I covered this in a lot of depth in episode 47, so if iron deficiency is something you're dealing with, please go back and take a listen to that one. But the short version is a low ferritin is not just a number to correct. It's a signal that there's something else to investigate because it can be a clue that there is something else going on, and it could be that your menstrual losses are really heavy. It could be you're losing blood from your GI tract, which can signal something quite serious. It can be a problem with iron absorption, or in some cases, it can signal that there's another autoimmune disease going on, like celiac, that's interfering with how you absorb your nutrients. On the other hand, when ferritin is elevated, it can behave as what we call an acute phase reactant. That means it rises, sometimes a lot, in the presence of inflammation or infections, not because your iron stores are suddenly high, but because the body is inflamed and reacts in a different way. So this exact same lab value can mean two completely different things depending on the clinical context. And so that is why we can't just interpret that one lab in isolation. There is another category of inflammation that I want to introduce, and this is where I think the conversation about food in Hashimoto's has been really incomplete. So when we talk about inflammation in autoimmune disease, most people are thinking about the immune system reacting to something it shouldn't. That might be thyroid tissue in the case of Hashimoto's, or it might be an antibody reaction to a specific food, and that's where the gluten conversation can become meaningful, or it can be a different food. And we're gonna address that directly and in depth later in this series. But today, I want to talk about the second type of inflammation that is at least as important in this population, and it is driven not directly by the immune system, but by metabolic dysfunction, specifically by insulin resistance and blood sugar dynamics. Here's how it works. When we eat foods that cause a significant rise in our blood sugar, meaning refined carbohydrates, sugar, sweetened beverages, even some foods we think of as healthy, the pancreas releases insulin to bring that blood sugar back down. This is normal and appropriate. The problem arises when there are body cells that are resistant to the signal of insulin and require more and more insulin before they will take up the glucose load. This can happen for a variety of reasons, from genetics to chronic high carb intake, to loss of estrogen, to abnormal thyroid signaling. Body tissues that can be resistant and require higher levels of insulin can be your muscle, your GI tract, your liver, fat cells, brain tissue, or the pancreas itself. And the pancreas, for a long time, usually can keep up with the elevated need for insulin, so the blood sugar doesn't tend to rise, and the problem may go unrecognized. But meanwhile, insulin levels in the blood are often double or more of those of people who don't have insulin resistance. And in addition to driving excess fat storage, insulin itself is a pro-inflammatory molecule. So elevated insulin drives systemic inflammatory signaling, further drives up elevated cortisol levels, which worsens autoimmune conditions and impairs mitochondrial function. So high and fluctuating insulin levels also directly drive symptoms like energy crashes, dizziness, anxiety, mental fog, fluid retention, and visible swelling, among others. And critically for thyroid patient, it directly interferes with the conversion of T4 to T3. This is a significant problem because if you have Hashimoto's, there's often already some impairment in that conversion process. So if you layer insulin resistance on top of it, it amplifies that problem even more. And the frustrating part is that insulin resistance often does not show up clearly on the routine labs that your doctor orders. Studies suggest that insulin resistance affects up to 70% of patients with Hashimoto's. That's roughly double the rate that's seen in the general population. So your fasting glucose can be normal. Your A1C can technically be normal because it only measures blood sugar. But the process is already underway, and it's contributing- to how you feel now and to long-term effects down the road. So how do we get a practical, accessible sense of whether metabolic inflammation is playing a significant role in your case? Here's a tool I use clinically, and it comes from a lab panel that most of you have already had done probably many times. So go back and get your most recent fasting lipid panel, your cholesterol check. Find your triglyceride value and your HDL cholesterol values. Divide the triglycerides by the HDL. This will give you a ratio that is a very useful clinical proxy for insulin resistance. So if that ratio is below about 1.5, your metabolic health is generally in a reasonable place. If it falls between 1.5 and 2, there's earliest insulin resistance developing, and it's worth paying attention to. If the ratio is above 2, insulin is likely a significant contributor to your symptoms. And if it's above 3, it's probably your number one dominant issue and the primary driver of systemic inflammation in your body at this point in time. Now, this is not a perfect test. There are situations where it can be misleading. And if you have a specific lipid disorder or are on cholesterol-lowering medicine, you'll want to discuss this with your own physician rather than just interpreting that in isolation. But for the majority of patients with Hashimoto's, it often provides a remarkably useful snapshot, and it points towards different dietary emphasis depending on where you land on that scale. Here's the TLDR version. If your energy is a roller coaster with peaks and crashes and cravings for carbs and difficulty going without food for more than an hour or two, metabolic inflammation is very likely a significant factor for you. If your weight is not an issue, but you have swelling, pain, brain fog, bloating, the picture may be less about insulin. The same dietary pattern helps, though, but the difference is in degree, not in direction. So The most important shift I want to offer to you today is this. Before we talk about removing anything, let's talk about what you should add to your diet. The anti-inflammatory dietary pattern that has the strongest and most consistent evidence behind it is the Mediterranean diet. This is well-described in many reliable sources across the internet, and at its core, this is a dietary pattern that emphasizes whole and minimally processed foods, fresh vegetables, fruit, fish, especially fatty fish like salmon and sardines, olive oil, avocado, avocado oil, legumes, nuts, seeds, whole intact grains in moderate amounts, fermented foods, and generous use of herbs and spices. It reduces processed meat, refined sugar, refined flour, sweetened beverages, and industrial seed oils. And when I say this pattern has strong evidence behind it, I want to be specific about what that means, because I know some of you have heard that phrase applied to a lot of things that don't deserve it. But the Mediterranean dietary pattern has been associated in very large, well-designed studies with lowered levels of CRP and other inflammatory markers, improved insulin sensitivity, better cardiovascular outcomes, cardiovascular disease being an inflammatory disease, and reduced all-cause mortality. There was one study, a 2024 review in the British Medical Journal, that looked specifically at the dietary components and their effect on inflammatory markers. And the foods with the most consistent anti-inflammatory signals were omega-3 fatty acids from fish, monounsaturated fats from olive oil and avocado, antioxidants from fruits and vegetables, polyphenols, fiber, fermented foods, and spices, particularly turmeric paired with black pepper, which apparently significantly increases the absorption of curcumin, which is the active compound in turmeric. That list is essentially a description of the Mediterranean diet pattern. Now, I'm going to be straight with you about this because we do not have large randomized controlled trials specifically in Hashimoto's patient showing that this diet reduces antibodies or improves thyroid function. That research would be very difficult to do well, and it largely hasn't been done. What we have is strong mechanistic evidence, meaning we understand why these foods reduce inflammatory signaling at the cellular level. combined with robust population-level data on outcomes. That is enough for me to recommend it with a lot of confidence as the best available starting point for your new eating plan. So what's important for our purposes is this pattern is really flexible. You can modify it towards lower carbohydrate if it turns out insulin resistance is your dominant issue, and it can be broadened to include more whole grains and other starchier legumes and root vegetables if metabolic health is more stable. It's not an all-or-nothing protocol. It's a direction. It matters specifically for Hashimoto's patients who have been told to eliminate gluten because for well who have been told to eliminate gluten because what's happening is a well-constructed Mediterranean diet pattern already reduces your exposure to the most problematic inflammatory inputs, much of which contain gluten, processed flour, refined sugar, sweetened dairy, packaged foods and snacks. And it does that by adding healthier alternatives and without requiring the kind of vigilance and restriction that a real honest-to-God gluten-free diet or dairy-free diet demands. It gives your body better inputs before you ask it to do the hard work of identifying specific sensitivities to foods. I cannot tell you how many patients I have seen who spent two years or more eating gluten-free, dairy-free, soy-free or more and still didn't feel well and who made much more meaningful progress when we shifted the focus to nutritionally dense and metabolically stabilizing foods rather than continued over-restriction. Not because gluten and dairy never matter for anyone. That's not true. But because those questions are easier to answer from a metabolically stable, well-nourished baseline. So here's a few starting points. These are examples of what this pattern can look like when it is simple and real. It's not a diet. So I generally always encourage people to start with a savory breakfast, and I wanna start here because this is probably the single most impactful change that most people can make. The standard American breakfast, cereal, toast, a sweetened yogurt, a muffin, even most of the smoothies, create a significant insulin spike first thing in the morning. Add your sweetened coffee drink, that's basically dessert. So that spike is followed by a crash in blood sugar, and that crash sets the tone for the entire day. So when patients tell me their energy is a rollercoaster, the first thing I look at is what are they eating for breakfast? A savory protein-forward breakfast stabilizes blood sugar from the start. The simplest version of this is eggs or some other kind of protein in any form you like. Two or three eggs, meat optional, cooked in olive oil or butter with vegetables on the side. If you're gonna have toast, go with whole grain toast rather than sweet pastry products, unless you feel better with fewer carbs, in which case don't have any toast at all. Then sauteed greens or sliced tomatoes or whatever leftover roasted vegetables you have from the day before. Doesn't need to be elaborate. If you can cook some eggs, you can do this. Now, if you want something you can prepare ahead of time and simply reheat during the week savory egg bites are one of my favorite quick, easy suggestions. So whisk together eggs with a little heavy cream. Pour the egg mix into a greased muffin tin. Season it however you like. Top each one of these with whatever vegetables, green peppers, red peppers, protein you have on hand. I like chopped spinach, diced peppers, crumbled feta, chorizo, or just eggs and herbs if you're keeping it simple. Bake 'em for about twenty minutes and then put 'em in the fridge or freeze them. You can reheat it in a minute and require no thought in the morning if you have no time. That is the kind of low friction, high return exchange I'm talking about. Fiber. We gotta talk about fiber because fiber is one of the most consistently anti-inflammatory inputs you can add to your diet. It feeds your beneficial gut bacteria. It slows the absorption of glucose. It reduces the circulating inflammatory markers, including that CRP we were talking about. The easiest way to add fiber without complexity are seeds. Legumes like lentils and chickpeas, vegetables, especially broccoli and other cruciferous vegetables, nuts and whole intact grains. Fresh fruit is an okay source as well, particularly berries, which are much higher in fiber and polyphenols and relatively low in sugar. I do want to flag dried fruit here specifically because while it does contain fiber, most commercially dried fruit is a very concentrated source of fructose and is frequently processed with added sugar. Fructose is metabolized different from glucose. It goes directly to your liver, and it drives fat storage and inflammation even when it doesn't produce a dramatic blood sugar spike. So fresh fruit in moderation, yes. Dry fruit as a fiber strategy, not really the good plan. Healthy fat as a default. So one of the most powerful shifts you can make with almost no additional effort is to add fat to your food. What? Oh my God, your mom's turning over in her grave, right? Fat with meals satiates your hunger better and longer than carbs. Extra virgin olive oil drizzled over almost anything, on vegetables, in dressings, over your eggs. This is not just flavorful. It generally has a meaningful anti-inflammatory effect. If you're gonna cook in higher heat like sautéing, you might wanna use avocado oil and or whole avocados are a great way to add some healthy fat to your diet. And I wanna say something really clearly. I don't think you need to fear saturated fat. So a good quality butter, plain full fat yogurt or coconut oil, these are not the enemy. The foods that consistently drive metabolic inflammation are refined sugars, refined flours, sweetened beverages, and industrial seed oils like corn oil, canola, and soybean oil. Not butter, not eggs, not full fat yogurt. Now, a note on yogurt specifically, I am recommending the plain yogurt. Not vanilla, not flavored, not triple zero, not the kind with fruit on the bottom or granola on the top. Those things are closer to dessert than the fermented food I'm recommending, which is plain full fat Greek yogurt with something you add yourself like frozen berries or a tiny drizzle of honey if you're not insulin resistant, a splash of cinnamon and vanilla extract. It's a different food entirely. It has protein. It has healthy fat. It has live cultures that support your microbiome. It is worth the habit change of buying the plain version and using a little bit of frozen fruit in there. Then Add something green. This is not a dramatic overhaul of your diet, just the added extra vegetables in whatever form is simplest for you. A handful of spinach added to your scrambled eggs, a little bit of carrots alongside whatever else you're eating for lunch. Broccoli sauteed in olive oil and garlic. The fiber, the micronutrients, the phytonutrients in dark green vegetables have consistent anti-inflammatory effects, and they are among the most nutrient-dense foods you can eat. All right, so what do we substitute? I said this episode is about adding, not subtracting, and the most sustainable way to reduce the foods that drive metabolic inflammation is to replace them with something better, not just remove them. But for sweetened beverages of any kind, you really do need to get those out of your diet. So let's substitute sparkling water, plain water with citrus added, or unsweetened tea or coffee, maybe with a splash of heavy cream. White starches should be substituted because rice, bread, potatoes, and breaded or fried anything, because these cause rapid glucose spikes and provide minimal nutrition, are one of the most reliably inflammatory inputs in the standard American diet. So we need to substitute whole grain breads, brown rice, quinoa, farro, lentils, or legumes, which deliver fiber alongside their carbs and slow the glucose response down. And packaged ultra-processed snack foods, anywhere the ingredients list has long and unfamiliar words on it, substitute things like nuts or olives or pickles or a hard-boiled egg. I'm not asking you to never eat these things. I'm asking you to reduce them steadily and replace them with foods that actually nourish your body, your thyroid, your mitochondria, and your immune system. If you must eat a high-carb gut bomb, eat it after your non-breaded protein for a blunted release of insulin and less blood sugar spiking. So if you have sugar cravings, I need to really be blunt here. If you've been relying on sweetened beverage and sweet snacks for energy, and I include here not just soda, but sweetened coffee drinks, flavored creamers, all fruit juice, most smoothies, you may find that removing them is the most rewarding thing you can do to reduce inflammation. But a gradual approach is usually destined for failure because your body will keep signaling that it wants something sweet, usually mid-morning or mid-afternoon. The craving for sweet can come from true hunger Or the need for a dopamine hit because you're hitting a wall at work, or just because you're used to it. If it's truly hunger, it means you're not getting enough protein and fat with your meals, but it may come with withdrawal symptoms, and giving in can erase days of progress. So it's really best to do it cold turkey, not gradually. It takes about 10 days to wean yourself off of sweets, during which time even non-caloric sweeteners are gonna cause problems for you. The reason is something called the cephalic phase of insulin release, because your brain anticipates sugar the moment it detects that sweet taste, and it releases insulin preemptively before any glucose has even entered your bloodstream. So the insulin spike then drives a blood sugar drop, which paradoxically increases the cravings and keeps that cycle going. So diet sodas, sugar-free syrup, non-caloric sweetened anything is not a neutral substitute during this transition. They're keeping that craving loop active. So what this transition actually feels like is worth knowing ahead of time, because if you're prepared for it, you're much less likely to give up. So your brain and your body may have been accustomed to regular dopamine spikes from sugar, and when those stop, there's a recalibration period that can genuinely feel like you have the flu. It's sometimes even called the sugar flu or the carb flu. Headaches tend to peak around day two or three. Fatigue, irritability, mood swings, and difficulty concentrating are all common in the first several days, and I've even had people tell me they ran fever. The physical symptoms will usually ease after about day five to seven, though the psychological cravings can linger a bit longer. This is not a sign that something's wrong. It's a sign that something is changing for the better, and the bacteria in your gut are crying out. Those are the bad ones. You want the good ones. A few things that can help: salt is surprisingly effective. Sugar cravings are sometimes actually sodium cravings in disguise, and replenishing electrolytes Can quiet the signal quickly. So a cup of good quality broth, or a few olives, or some pickle juice, or a little pinch of sea salt in some water can abort a craving within minutes. Magnesium can also really help. It supports blood sugar regulation, reduces the headaches that tend to accompany this transition, and magnesium glycinate at bedtime is my preferred form. Staying well-hydrated also matters more than usual during this period, and when cravings hit and you know it's not real hunger, it often doesn't last long. A five-minute walk or a few deep breaths or any physical movement, jump up and down at your desk for a second can be enough to let it pass. I'm not prescribing any of this as a requirement. I am sharing it because I have seen how much easier this transition is for people who know what to expect and have some tools ready. All right, so I want to close by explaining why I'm asking you to start here with an adding in, nourishing approach, substituting out for the more harmful things that you've already been eating before we get to the question of gluten and dairy or any specific food elimination. The reason is simple. Elimination diets are asking a lot of your body and of your attention. They require sustained vigilance, label reading, social navigation, and consistency of follow-through. And if your body is not nutritionally stable when you begin that process, you are gonna get a muddy result and you're gonna get failure. Inflammatory noise from poor nutritional status and metabolic instability makes it much harder to detect the signal of a specific food sensitivity at the same time. The other reason is even more direct. Restriction is a physiologic and mental stressor. Under-eating, excessive food anxiety, and chronically elevated cortisol from the stress of navigating a really restrictive diet all interfere with thyroid hormone conversion. Cortisol releases reverse T3. Elevated reverse T3 blunts the effect of circulating T3. Your thyroid is working hard to make. The restriction that's meant to help can, in some patients, actually worsen their very energy that they're trying to support by taking care of this. A well-nourished, stable metabolic foundation makes every following step easier. It makes the elimination and challenge process, which we're gonna walk through in detail later in this series, more informative and more accurate. And if it means that it turns out you do have a specific food sensitivity, or if you do get tested and you find out that you have celiac disease, removing that food will be a much smaller ask against the backdrop of a generally more nourishing dietary pattern. So let me leave you with this framework as simply as I can state it. If your energy is a rollercoaster with crashes after meals, persistent cravings, and difficulty going without food, start by stabilizing your blood sugar. Add protein to every meal, especially breakfast. Add healthy fat. Reduce the refined carbohydrates and sugar. You don't even need any extra labs to start here. If your weight is more stuffy, but you've, If your weight is more stable, but you still feel puffy, achy, and persistently unwell, focus on food quality and diversity. More omega-3 rich fish, more olive oil, more variety in your vegetables, more fermented foods, more color on your plate. And in both cases, start with a single change, just one, not 10. The patients I watch make real lasting progress are not the ones who overhaul everything on day one and then give up because it's too complicated. They are the ones that pick one genuinely supportable change and make it a consistent habit before moving on to the next one. You don't have to do all of this at once. Pick one thing, do it consistently. That's how this works. So if you haven't yet grabbed the food tracker, this is a great companion to what I've been discussing today. It's a printable PDF and a custom AI prompt that helps you track everything you're eating. You can download it free at danagibbsmd.com/tracker, or if you're watching this on YouTube, I'm gonna put the link in below. And if you've already started with the food and symptom diary I introduced in the last episode, keep going. What you're learning about your own patterns right now is gonna become really useful when it comes time to plan your own custom elimination and challenge diet. So in the next episode, we're gonna go directly to gluten, and the real story, not the online version. We're gonna look at what gluten actually does in your gut, what zonulin is and why it matters, who is genuinely susceptible to in-increased intestinal per-permeability, and what the evidence actually shows about gluten outside of celiac disease. It is the most important and most misunderstood piece in this entire series, and I wanna give it the thorough treatment it deserves. I'll talk to you again very soon. Thanks so much for listening.

33:26

Thank you for listening to this episode of Beyond the Thyroid. If you found this information valuable, it would mean so much to me to take a few seconds and give the podcast a five star review. It helps other people who need this information find the show and it's really easy. Just search and click on the name of the show, Beyond the Thyroid, and scroll to the bottom to ratings and reviews. I truly do read and appreciate. Remember, when it comes to hormones, there will always be more to discover, so follow the show so you get the next episode as soon as it's released. And if you or someone you care about needs a caring doctor to help figure out how to heal hormone problems that other doctors have dismissed, check out my website at www. danagibbsmd. com. And if you're not a physician, please keep in mind, while I'm a doctor, I'm not your doctor. The content of this podcast is my opinion and it's for educational and entertainment purposes only. This is not meant to be individual medical advice and you should consult your own physician for any medical issues or diagnoses that you may have. I look forward to continuing this journey with you beyond the thyroid.