Hashimoto's, Self-Advocacy, and Building solaia.tech with Lindsey Patrice Perez

Beyond the Thyroid - Episode 54: Hashimoto's, Self-Advocacy, and Building solaia.tech with Lindsey Patrice Perez

Lindsey Patrice Perez was nine years old when she was diagnosed with Hashimoto's disease. What followed were years of fatigue, brain fog, dry skin, and weight struggles and years of being told her labs were fine.

She learned to track her own symptoms, push for expanded testing, and show up to appointments with a concise one-page clinical brief that changed how her doctors listened to her. Then she built an app to help everyone else do the same thing.

In this episode, Dr. Dana Gibbs sits down with Lindsey, the founder of SOLAIA, an AI-powered health advocacy platform, to talk about what it really takes to get answers when the standard system keeps telling you nothing is wrong.

In this episode you'll learn:

• What it's like to grow up with Hashimoto's and spend years searching for answers
• Why "in-range" labs don't mean you're well -- and which labs actually tell the full story
• How a one-page clinical brief can turn a 20-minute appointment into an informed conversation
• The PMOS (formerly PCOS) and Hashimoto's overlap -- and how metabolic testing revealed what standard panels missed
• How GLP-1 therapy helped Lindsey's insulin resistance and what it required for thyroid medication monitoring
• Dr. Dana's own story of waking up to the limits of TSH-only testing
• How to find a doctor who will actually partner with you -- and when to walk away
• What to do first when your labs look normal but you know something is wrong
• How SOLAIA works, what the one-page brief costs, and what's coming next

If you've ever walked out of an appointment feeling dismissed, or been told your numbers are fine while you're still exhausted, this episode is for you.

🌐 Learn more about SOLAIA 

👤 Connect with Lindsey Patrice Perez

📑 Join the The Thyroid Clarity Checkup Priority List! 

📁 Get My Free Lab Ordering Guide for Thyroid Health

🎯 Get The Free Food Tracker!

📲 Follow Dr. Dana Gibbs on the Goodself App!

🩺 Interested in a Discovery Call with Dr. Dana? Click here!

📺 Watch on YouTube

Episode Highlights

00:00 Welcome and Guest Intro
02:08 Diagnosis at Nine
03:40 Living With Symptoms
04:53 Fatigue and Skin Clues
06:59 Learning Self Advocacy
09:06 Finding the Right Doctor
10:57 Weight Struggles and Resilience
14:12 Better Labs and PMOS
16:12 GLP-1 and Med Adjustments
18:42 Healthcare System Wake Up
20:30 Doctor Dana Personal Story
24:23 Why I Quit Insurance
25:49 Start With Symptom Reflection
27:39 Ask For Full Thyroid Labs
31:00 When To Switch Doctors
33:27 Win The 20 Minute Visit
38:52 Tell A Better Symptom Story
41:00 Insurance Barriers Explained
43:00 Solaia One Page Brief Tool
45:45 Future Vision Smarter Tracking
47:25 Labs Normal Not Well
50:04 Thyroid Clarity Checkup Program
52:32 Reviews Disclaimer Wrap Up

Let's connect! 🔔
Facebook - Consultants In Metabolism
Instagram - @danagibbsms
LinkedIn - Dana Gibbs MD
Tiktok - @dana.gibbs.md

✉️ 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 0:00

Hello. Welcome. Today, I have something real special for you which is a guest episode with Lindsey Patrice Perez. She is the founder of SOLAIA an AI-powered health advocacy platform that bridges the gap between women with complex hormonal conditions and the doctors who treat them. So she is based in Los Angeles, California, and has built this AI platform after her own Hashimoto's journey, which started when she was just nine years old. So I think you guys are gonna really like this, and let's go ahead and get started. All right. Welcome, everybody. If you're new here, welcome back to Beyond the Thyroid Podcast. I am Dr. Dana Gibbs. I treat Hashimoto's and thyroid and other hormone diseases that other doctors have not been able to fix. So today, I have something special for you guys. I have Lindsay Perez. She is the founder of SOLAia, which is a health advocacy platform women who have hormonal conditions that are complex, and also doctors that treat them. She built this after she spent a really long time with Hashimoto's herself, and what her product does is it generates a brief one-page clinical document that you can take into your doctor's office that helps your doctor see a snapshot picture of exactly what's been going on in the language that your doctor will understand. It turns your appointments into informed conversations instead of 20 questions. Lindsay is a Latina business founder and patient advocate on a mission to be ensure that no woman with hormonal conditions ever has to advocate alone to be understood. So welcome, Lindsay. It's so great to have you here. And,

Lindsey Perez 2:01

Thank you. Thank you so much. Absolutely. Let's do this. Thank you so much for that warm intro. That was wonderful

Dana Gibbs MD 2:08

All right. So take me back to the beginning. You were nine years old. How did you first know something was wrong? What did your doctor tell your parents and you? Tell me the story

Lindsey Perez 2:23

Let's go back. So I was nine years old when I was diagnosed, but something that happened very previously to that, to being diagnosed was over one summer I gained about 15 pounds. So that was my one huge indicator to my doctor and to my parents. They were alarmed. That's not normal. It's not normal to gain 15 pounds. Nothing changed in my eating habits or my exercise habits. It was just a jump. And so that was immediately a flag to my doctor to get a full thyroid panel and look at exactly what was going on internally, and that's when I was first diagnosed with hypothyroidism Hashimoto's. And I believe my TPO antibodies were around 12,000, which

Dana Gibbs MD 3:09

Oh,

Lindsey Perez 3:09

was meant. Um, so yeah, that was the beginning of the story. It was very scary I think initially.

Dana Gibbs MD 3:17

at the time?

Lindsey Perez 3:19

I don't. I don't remember what my TSH was at the time. I just know that my TPO antibodies really stood out to my doctor and they made it apparent to be like, "Yeah, this is-

Dana Gibbs MD 3:29

I think it's funny because there's a lot of doctors who wouldn't have even ordered TPO antibodies on you good on your first doctor. So what happened then?

Lindsey Perez 3:40

After that, I got the call, my mom got the call, it w- I was officially diagnosed, and I've... was on Synthroid for 10 years, going every three months to a doctor, basically living with the symptoms that I thought were normal. Growing up I didn't know what the difference was to have my hormones balanced versus not. So I just grew up thinking, "Oh, brain fog is normal. Fatigue is normal. I have to push through. I have to keep pushing through. Exercise like this should feel normal. I should feel this tense rather than relaxed after certain exercises." I just thought it was normal, so I lived with it for over 10 years until I was, I believe, 22. And then life got a little bit harder, things got a little bit rougher, and I thought, "You know what? This is actually not normal. This isn't normal." So I took a really long time to look at myself and advocate for myself in doctors' spaces with my doctors, and really tried to push for the most complex thyroid panel that I can, and I'm still on this journey today. But it's something that I'm much more closer to having balanced and feeling much better than I was

Dana Gibbs MD 4:51

That's,

Lindsey Perez 4:51

even a few years ago

Dana Gibbs MD 4:53

What was it that was finally the clue?

4:57

It's oh,

Dana Gibbs MD 4:57

other people are not like this. This is not normal

Lindsey Perez 5:00

I think the first one for me was fatigue. Fatigue was a very big one for me. Chronically being fatigued after sleeping over nine hours, that was a big red flag for me. I realized some of my peers would sleep a proper seven to eight hours and be good for the rest of the day. They wouldn't need a nap. I needed a nap even. I needed a break. I could not push. College was a really rough time for me because of that, obviously, because the schedule of college is just... It's up and down, left and right, changes all the time, and I think one thing that I learned about myself recently is I need routine, and I need routine to be very stagnant and that's what's helped my hormones as well. But ultimately, it was the fatigue that really sent me over the edge, because I didn't wanna feel tired anymore. It got really frustrating to not be able to work a proper nine to five without feeling absolutely depleted at the end of the weekend and

Dana Gibbs MD 5:56

Sure

Lindsey Perez 5:56

it to actually rejuvenate and build myself up rather than enjoying it. So it was that juxtaposition of just feeling really stressed and really tired versus building myself up over the weekend that really allowed me to reflect. Fatigue, for sure. And I think another one for me was my skin. So my dry and itchy skin. I didn't realize that wasn't normal to have. I just used specific lotions my whole life, and I just thought, "You know what? This is normal. This is normal to have itchy and dry skin. This is normal to have a certain amount of hyperpigmentation." And it wasn't. It's not normal. I just thought it was,

Dana Gibbs MD 6:38

Yeah

Lindsey Perez 6:39

I just thought it was

Dana Gibbs MD 6:40

So once you came to that realization, "Hey, I'm not like everybody else. This is not right." you were already on Synthroid. Your numbers were perfect, I'm guessing,

Lindsey Perez 6:55

They were in range. They were in range. Yeah, they were in range

Dana Gibbs MD 6:59

Once you figured that out, once you said, "Hey, I'm not as good as I could be. I should be better than this," long did it take you before somebody in the medical world took you seriously, and what did that finally look like?

Lindsey Perez 7:15

This is another part of the journey that is really complex, I think, for everybody. Seen up to four different endocrinologists throughout my life. When I was 18... Obviously, from nine to 18, I had the same one I was underage. As soon as I be- became 18, I started to be assigned different ones. As my condition became more and more intense, I realized I needed more and more help, and that's what pushed me to open that conversation with different endocrinologists. And I realized I was hitting a few walls,

Dana Gibbs MD 7:47

Yeah

Lindsey Perez 7:48

I was hitting a few pushbacks because I was attempting to go into the appointments, obviously a bit nervous because I didn't learn how to advocate for myself in a doctor's office. That's not something that I've ever learned. So I entered the spaces, and I just told them my generic symptoms of I'm tired all the time, my skin feels itchy, I can't lose weight, and that wasn't very helpful. That wasn't very helpful from a clinical side, is what I'm learning today. And after hitting a few walls, I realized, you know what? It's time to, it's time to log it myself. It's time to be very specific about what I feel and how I feel in terms of what I'm eating, in terms of how I'm exercising, how I'm sleeping. It... Basically I did a little bit of an intervention on myself and was very self-aware for a while in order to be... in order to enter an office, a doctor's office in an appointment saying "This is what I feel. This is exactly when I'm feeling it, and I would like to learn more about why, because I do not feel like this is normal." And it isn't

Dana Gibbs MD 8:54

Yeah. No, I agree. So I'm sure, if weight was one of the problems that you went in with, I'm sure that you have gotten the party line, move more, eat less, and just wow. So do you feel like even at this point that you have someone who, not that will advocate on your behalf, obviously you're learning to do that yourself, but someone who will take you seriously and help you try different things advance your recovery? Do you feel like you finally found somebody?

Lindsey Perez 9:26

I believe that it is still a journey that I'm on. I do have an endocrinologist that is very open to hearing my symptoms and reading my brief, which is amazing, and that's exactly what I'm there for. I think that is a huge part of the journey, finding somebody that is your partner on this journey, that is, whether that's a PCP, functional medicine doctor, endocrinologist, any specialist to have on your side is crucial, but it's also hard to find. I'm very thankful that I have found somebody that is willing to read my document and willing to be open to that. So yes, I have. It was a very long journey. And I've also switched PCPs about two different times. So It's been a few roundabouts here and there, honestly. But yes, coming back and forth it has been rough, but I'm very thankful that coming with a document like I've been able to generate has really been able just to open the conversation, but also it allowed me to be more confident in that room of "No, this is exactly what I feel. This is exactly what I'm feeling. This is how I'm feeling it and why, and I would like it to change, so can you please help me change that?" I think that's a key component in it

Dana Gibbs MD 10:43

Yeah. And what was it that finally the needle for you as far as you stopping waiting for somebody else to figure it out and it out more or less for yourself like that?

Lindsey Perez 11:00

Life became a bit harder

Dana Gibbs MD 11:05

Aha

Lindsey Perez 11:06

of personal issues. Life goes on. Hard things happen. And I just realized that I didn't wanna feel the same way that I've been feeling my whole life, very stagnant in my fatigue, The way that my skin feels, in the way that I felt in my body. I wanted to feel more fluid, honestly. I wanted to be able to do the things that I love without feeling like my symptoms were a barrier and without feeling like I couldn't do certain things because I was tired, or I couldn't feel certain ways because I felt overweight and a bit sad at times because everything that I was doing was not working. I think another thing that I wanted to mention that you briefly talked about was my weight. That was a large part of my symptoms, too, growing up. So I played sports my whole life. I played sports. I grew up with two older brothers, so naturally I was active all the time. I ate very clean. I ate very clean as, as much as I could, and that was something that was not moving the needle. And at one point, frustration like that just builds and builds. I'm doing absolutely everything right according to my physician, but nothing's changing. And so that, after over 15 years, that really built a lot of just resilience in me to be like, "You know what? Something else is happening, and it's time to look inward."

Dana Gibbs MD 12:29

Yeah. Yeah, one of the things that I notice, is that when this condition hits a man, which is only about 1 in 10 of us they very quickly get attention. They very quickly... when you go in and you say, "Yeah, I gained 40 pounds and I didn't change anything." And they get mad. If you tell them, "Oh, you're just getting older," they just, they get mad. Women, I don't know why it is that we put up with it, but it seems like we put up with it, all these excuses. "Oh, it's just your cycle. Oh, it's just PMS. You just have to live with it. Oh, you're just getting older." I don't know. It's the kind of advocacy that you're talking about should be really top of mind. Really, I think women have just had this cultural, "Yeah, it's gonna suck, so you just have to live with it," and it doesn't need to be there. How.. Can we make this more into something that gets the proper amount of attention? And I'm still looking for that. I try to teach doctors. That's my big mission, is I wanna teach doctors a better way to manage Hashimoto's in particular, thyroid in general, and it's hard to get them to listen. They're just... They're very invested in this, "Oh it's just, you're just a whiny woman. You just need to suck it up." so what was it, what was the one thing that kind of finally moved the needle for you? A test, a different provider, a different piece of information? What was it that started you off on, "Okay, I can be better"?

Lindsey Perez 14:12

After meeting with my fourth endocrinologist and getting the right labs done, that was a full thyroid lab. I tested everything from vitamin D to vitamin B to iron, everything. I wanted to know Absolutely everything to understand exactly why I'm having the symptoms that I'm having at that time, and at that time it was hair thinning, my skin was still dry, my weight was still stagnant, I was still very tired my hands and feet were also cold. My temperature, my body temperature was out of whack, honestly. So after, after getting those labs done and getting a clearer picture, I realized that I also may have had PMOS, which is now the new saying, fantastic, and because of my androgens,

Dana Gibbs MD 14:59

that. It's okay, h-

Lindsey Perez 15:00

absolutely

Dana Gibbs MD 15:01

It's the same disease, but, know it actually, it actually brings to the forefront, "Hey, this is actually a metabolic condition, and there's something we can do about it." Rather than just, "Oh, it's just PCOS, you just have to live with it," it's,

Lindsey Perez 15:16

Exactly

Dana Gibbs MD 15:17

a metabolic condition. So I'm actually really glad about that, so

Lindsey Perez 15:20

Me too. And it goes back to what you're saying about the whole advocacy, men versus women. It is primarily a woman disease. Autoimmune diseases affect, what, three times the rate of men in the United States. And so being able to advocate like that and being able to have the research done is a feat in and of itself, and I'm glad that it's getting done. I am. Me too. I, as somebody who was recently diagnosed with it, I'm glad that there's movement towards it, and it's a journey. That is something that I tell every person that I work with. It's a journey, and the great thing is you're not alone, and there are spaces to advocate, and there are spaces to help you, which is exactly what you're doing. I think that's the beauty in it. Having the education and the communication is exactly what's needed, and there's such a big gap for it. So I think it's honestly phenomenal work

Dana Gibbs MD 16:11

All right. So you got the co-diagnosis of PMOS. what else did you need to do? What else have you done that seems like it's actually helping you recover?

Lindsey Perez 16:23

GLP-1. GLP-1 is, I think, a really large one for my insulin resistance. That has been extremely helpful for my weight,

Dana Gibbs MD 16:32

Oh, okay

Lindsey Perez 16:33

That is something complex that I have tried that has helped me with my weight loss, which is another symptom that I'm constantly treating and because of my GLP-1 and losing weight for the first time, I think in over, honestly over 10 years, which

Dana Gibbs MD 16:49

Wow. Okay.

Lindsey Perez 16:50

sounds insane. Yeah, it's what-

Dana Gibbs MD 16:53

that's really good. I it's shocking to me how few people notice know that the overlap of metabolic disease, insulin resistance and Hashimoto's is over 70%. It's just enormous. So yeah, it's good that's finally coming out into the forefront and that getting that managed really does help. With regards to your thyroid, did they decide you needed to change your medications or are you still doing your same Synthroid that you were always doing?

Lindsey Perez 17:26

I decided to change my medication when I was 18, so I went from... I just went from Synthroid to levothyroxine, so it wasn't a huge jump. I've just been fluctuating between different dosages because of my weight and the complexity of it

Dana Gibbs MD 17:39

t4

Lindsey Perez 17:40

fluctuating. And so right now I'm just keeping a close monitor. I meet with my doctor once a month instead of three times a year because my weight is going down and that means that my, my thyroid medication needs to be adjusted or I would have hyperthyroid symptoms, which I didn't realize until I started losing weight really fast My thyroid was going out of whack for the wrong reasons and I was having heart palpitations. I was very shaky and I didn't understand what my body was doing and I realize now

Dana Gibbs MD 18:13

Yeah,

Lindsey Perez 18:13

I was being overmedicated. I was being overmedicated and I didn't realize that was an option. I just thought, "You know what? The more medication, the better." And I learned very quickly that is not the case. So just keeping a close monitor on my Synthroid and understanding exactly what I'm feeling because at the same time as I'm having more balanced hormones, my symptoms are still apparent. So I think that's my number one priority, getting my symptoms under control

Dana Gibbs MD 18:41

Okay. So how did all of that change the way you think about our healthcare system? And I know that, we're here to kinda talk about what you're doing about it, but I wanna, I just kinda wanted to get to the, not very many people would go, "Oh, I'm having a terrible time. I think I'll make an app to fix it," and that's not the normal story that I get. So I wanna know what pushed you in that direction. I think that's really cool

Lindsey Perez 19:11

As soon as you asked that, I took a huge sigh, and I think that is such a complex question. I- my immediate reaction to that was I was... This journey has made me realize how disappointed I am ultimately in the healthcare that I've been able to access, and I just think having accessibility, and having advocacy, and having education should all be prioritized when it comes to any... at any level of healthcare, but specifically for women because we are under-diagnosed typically, under-researched on average, and just there's a large, there's a large gap as we've talked about. And ultimately, the disappointment is something that I've been able to not come to terms with, but made me realize that, you know what? This is exactly why I am doing what I'm doing. This is exactly why I work with women one-on-one, and it's exactly why when women come to me and say, "You know what? I was able to get the lab that I wanted," that is when it pays off. That is exactly when it pays off, and the healthcare system feels a little bit more accessible when women come to me with those stories, and that is exactly why I think... if I could rewrite it, there would just be a lot of differences in the healthcare system. But I'm curious to know from a physician's point of view how do, how would you take that question?

Dana Gibbs MD 20:30

I was here's the deal. I was fine until I was a senior in high school, and then I got sick, and it felt like I kinda never recovered my energy. And after that, I was always exhausted, I was always cold, I always needed a nap, just all the same story that you said. Thin hair, everything, eyebrows fell out. But I had decided when I was, like, 10 that I was going to medical school, that I was gonna be a surgeon.. And I almost let it stop me. I even changed majors to do something else, and I got to the end of college and I was like, "No, I don't really actually wanna do something else. I wanna be a doctor." And so I went and I did the thing. And, it got worse, and I was going to the hospital and I was passing out on rounds and, go to the doctor and they're like, "Oh, you're fine. Here, take an antidepressant. You're just stressed." I went through my entire medical school residency career feeling like, i'm always behind. I must not be as smart. I must not be as motivated. I'm just lazy," blah, blah, blah. I kept telling myself this in my head all the way up to, I'm out in private practice, And I went to this conference, and this guy stood up in front of the group and said, "You don't have to have an abnormal TSH to have thyroid problems and to be helped by thyroid medicine." And I'm like, "What are you talking about?" And he put up a list of symptoms, and of the 20 symptoms on that slide, I probably had 14 of them. And I'm like, "Oh my God, I have hypothyroidism." And so I started digging, and I went on Armour Thyroid, and it was like flipping a switch for me. It was like, "Holy cow, is this what normal people feel like?" Because it was so not my experience of life, because I had really convinced myself that I was normal or that what I was experiencing was normal for lazy people anyway, and once I got on that Armour Thyroid, I went back and I saw that list of symptoms in my head every day, and every s- every patient who would come through my clinic. I was doing ENT. All my patients have sinus and allergies, and some of them would have a lump in their neck from their thyroid and need it removed. And I would watch those people come in and they're fine, and then they have that lump taken out, and all of a sudden they gain 40 pounds and they feel like crap, and their skin is dry and their hair fell out. And I'm like, "Okay, their endocrinologist just told me they're normal, but I know that I can fix them with Armour Thyroid." And so I would say, "Hey, while we're waiting to do your sinus surgery, would you like to try this change?" You know- And watching people get better was a shock to me. I was kinda used to thinking outside the box because of doing allergy, which is a weird backwater of ENT. It's, mainstream allergy is different than ENT allergy in ways that I can't explain today. But they do a lot of this out of the box thinking. It's okay, you have a clinical symptom, you don't know what to do for it. You try something. If it works, okay. If it doesn't work, you do something else. And I finally found a mentor who explained to me what was going on with me. It's what are these people whose TSH is normal, whether or not they're taking levothyroxine, but they feel like crap? What can I do for them? And he laid it out, and, it's this big, long course. And I still work with that guy. I, he and I teach together, but yeah, there's so much more that can be done for somebody besides just hand them a prescription for TSH. And when I got the point in my life where I decided I was ready to not do surgery anymore, was like hell, I can't give up on these thyroid people. I'm just gonna keep going." And I now do, that's what I do all the time. And I had already decided many years before I left doing surgery that I hated dealing with insurance companies who tell me, all these stupid rules that are designed slow me down in helping my patients, to heck with that. And so I don't take insurance anymore, and I couldn't be happier. And unfortunately then people have to pay for me to do what I do, but I really feel like I can help people better in the education world. And if I tell you, "Hey, you need these five labs, and here's what the ideal numbers ought to be," and I tell that to, 1,000 people in a Facebook group, or even 20 people in a Facebook group, I've helped more people than I can see coming through my clinic in a day. And so I just decided, look, education is where it's at for me because I need to give back. So that's kind of it. But anyway, yeah, it's... I mourn the days before thyroid guidelines, which was about when I was going through medical school when people actually had to think to figure out what to do for you instead of just follow a guideline. But anyway, so with you and what you're doing, what is the first concrete thing you tell somebody to do when they suspect there's a problem, but they keep getting told they've had all the labs and that they're normal?

Lindsey Perez 26:04

I first have them reflect. I have them reflect on exactly what they've been feeling and for how long, 'cause I think that is the key to any documentation and to getting into your doctor's appointments and having that productive conversation. So if I have a client come in and she's very frustrated, let's say she is looking to conceive again, which is also very complex when it comes to thyroid issues, And she has been unable to get the proper labs done. Her doctor keeps pushing back about not getting the proper labs. I would then ask her, "Okay, what exactly are you feeling in your body? What is your plan? And what are you looking to get out of this? Are you looking to get a proper thyroid panel? Are you looking to get a closer look at more hormonal health, more, more hormonal external assistance?" And once I have those two things, I have them fill out a form that specifies exactly a little bit more about their history, if they've ever been diagnosed with any autoimmune diseases. So, when, how long, any key context, so specific symptom names, any medications that they're on. And I think a key part of this is the lab status, so any labs that they've had done previously, when they were done, and what the results were along with what labs that they're looking to get tested. Having that outline is really key, and overall, just going with that one ask is really key for a productive appointment from my experience

Dana Gibbs MD 27:38

Yeah. I think that's about right, so I'll just answer that same question. So the first that I tell people when they have that scenario, it's like you got told your labs are normal, everything's fine, you're just getting older, whatever. The first thing I'd say is, first of all, don't assume that the labs that were ordered were all of the right labs. TSH, which is what most people get, tells you only what your pituitary gland is doing. It doesn't tell you how your stress levels are affecting your free hormone levels. It doesn't tell you if you have a high level of inactivation of your thyroid hormone. it doesn't tell you whether you have mineral deficiencies or insulin resistance or any of a large variety of other parallel issues that are going on. so what I tell people is, "Look, we need to have you start by knowing what tests you need and then asking for them." And with thyroid, I say these all the time, it's TSH, it's free T4, free T3, total T3, reverse T3. And if your doctor has never mentioned those last three, it's not a failure. They're still following the guidelines. It's this gap in what they were trained. But you can ask for them, and you can name those tests. But if they don't order them, you can't expect them to know what to do with them once they get them. But you can go back and say, "Oh, look how low my T3 is. I think maybe I'd like to try Armour, Dr. Jones. Would that be okay with you?" and then come to an educational source that's legit from somebody who is, one, a doctor, and two, not trying to sell you anything. and by doctor, I don't mean a chiropractor or a physical therapist who's pretending to be a doctor. They're not a medical doctor, and it really drives me nuts when when I see people on there saying, "Oh you just need a liver cleanse." And I'm like, "Ugh, what the heck?" But anyway, okay so yeah, there's an education gap. I admit it. I'm trying hard to fix it. I wish more

Lindsey Perez 29:59

Doing wonderful job

Dana Gibbs MD 30:00

anyway, it's not a failure on your doctor's part that A, they don't have this knowledge, that B, they only have 15 minutes to talk to you. What you can do is exactly what your program is doing, Lindsay, which is have people organize their information such that the doctor sees it. If you, if you-- if somebody walked in and handed me this document and it said, "You have five years of chronic fatigue that started shortly after your first baby," "you also have these symptoms. Here's what you've tried. Here's the diet you're on. Here's the other diet you've tried. Here's what worked and what didn't." would be like, "Hallelujah." Because if I can read a document in three minutes, then we have the other 18 minutes to talk about what we're gonna do about it, rather than

Lindsey Perez 30:53

Hallelujah

Dana Gibbs MD 30:54

trying to get and spend the entire time dragging that information out of people one little piece at a time. I think that's really helpful So how do you know when you've had someone push hard enough with their current provider versus when they need to start looking for a different one?

Lindsey Perez 31:18

That's a great question. That's a great question as somebody who's seen multiple doctors and who's felt very... felt like there's been multiple doors shut in my face. I think it's really up to the patient. It's up to the patient to whether they're feeling supported in the ways that they want to. If they decide, you know what, they wanted a lab done, getting a full thyroid lab That their physician is currently pushing back on and that's not the support that they want, I tell them, "You know what? It's okay to look elsewhere." Is, which can be frustrating for a lot of clients 'cause that is, that's a, it's a long journey to look for a proper physician to look at your thyroid a little more complex and a little more closely. So really, it's up to the, it's up to the patient for me and my client

Dana Gibbs MD 32:07

Yeah. One of the, one of the things if I was a a patient, and eventually I'll be looking for my own doctor to, once I retire and don't treat thyroid anymore. There's two things that I would ask before I even make the appointment, and first of all is do they order more tests than just TSH and free T4? The second thing I would ask is do they treat by the numbers, or do they factor in how the patient feels? And you may actually have to ask somebody who works with that doctor one-on-one clinically, like the nurse. You may actually have to ask to talk to the nurse who works with that doctor, or a patient care coordinator or through reviews from other people who have seen that doctor or something like that. but if, if you read a review and said, "Oh, this doctor told me my labs were normal," and then wouldn't do anything else, then of course that's not the doctor you're gonna wanna be with. Yeah. I think people need to, they need to shop a little more thoughtfully for the doctor that they're gonna choose, and I think they need to be prepared to maybe even for labs themselves and order them themselves. That's one of the things that I actually help people do. But how do you have a patient prepare for an appointment when they know they have a lot of ground to cover and maybe only 20 minutes?

Lindsey Perez 33:35

I think, ugh, that's the complexity of every appointment. It's under anywhere from 15 to 20 minutes. So immediately I like to tell every woman going in, you have 15 to 20 minutes, you are prepared. You can advocate for yourself. You have all the evidence that you need. And I think that goes a long way just to know that you're prepared going into an appointment like that. And ultimately, I think I think it's a combination. I think it's a combination of going in with confidence and really understanding, you know what? You've put yourself out there in a lot of different ways. You have everything lined up exactly as you need it. Here you go. Really just, it's about confidence, which is something that women who've been necessarily looked away from or gaslit in a physician setting lack. Because I remember for over, for a really long time, I would go into my appointments very scared. I would go into my appointments scared because I knew exactly what was gonna come out of it. I knew I was gonna be told that my, my, all my symptoms or all my labs were in range despite how I was feeling, and that scared me. That scared me when I was unprepared because I didn't know exactly what symptoms were tying to my condition. After realizing that, and after studying myself a little bit more closely, I realized that. And I think more women in these spaces with your education and with a resource like mine can do that, and we can do it well, and ultimately make that appointment more productive, which I think is the key. Opening the conversation, which I think, again, going back to what you said about finding a physician, it's all, it's like dating. It's figuring out exactly which yeah, figuring out what works for you, clear communication, clear goals together onset. So yes, I think it's a combination

Dana Gibbs MD 35:26

Yeah. So I've had patients who walk in with nothing, and I've had patients who walk in really prepared. I'll tell you, I can do a lot more in a lot less time with somebody who's organized than I can with somebody who just, starts with one thing and expects me to magically read their mind about everything else. so I like the fact that you're advocating for a one-page summary, because sometimes I will get... know, somebody will bring in a book, 57 pages, and it's maybe one or two lab values a page, or it's it's 20 years of hospitalizations and random stuff that I'm like, "I don't know what to do with this. I can't, I don't have time to read this." But if you walk in and it's a one-page summary and it's when your symptoms started, exactly what they are which ones cause you the most distress what you've already tried, what specifically you're asking for as your goals, I think that's a super great way to do it. And it's not three or six pages, it's a page. are the most important things, and here's my one goal for today. And that's another thing that, that people don't understand. It's like they walk into a well visit. It's "Oh, I get a free well visit with my doctor every year." I'm sorry. The well visit is something that basically they read off a check sheet. "Oh, we have to check your cholesterol. We have to check your weight. We have to check your body temperature. We have to make sure you've had the right vaccines. Oh, you have to get this health maintenance because you're now 50 years old," or whatever. A, a well visit is something that's basically dictated by your insurance company, and they have to get through this certain number of things. if you're there because you're tired and because you want to deal with a specific condition, make an appointment that says, "I'm tired and wanna work on this particular thing." Be really specific and don't say, "Oh, doc, I have 27 things I want..." They don't have time for that. one. And yeah, you wanna pick the most important one, and you wanna tell them all the other symptoms that came along with it, but you can just make a list. You don't have to tell them 47 things about every symptom. It's just, you have to really be focused and you really have to be organized, and that really genuinely makes their job easier that you are much more likely to get what you came for. It's not pushy, it's practical. Okay? It's

Lindsey Perez 38:14

Fully agree

Dana Gibbs MD 38:15

super, super helpful, and yeah, I just, I can't emphasize that enough

Lindsey Perez 38:20

I agree. I know you mentioned that you used to have over-prepared patients. I used to be... I was more recently an over-prepared patient. I used to come in when I was younger with nothing. As I got older, I over-prepared And that kind of led to even more miscommunications with my doctor. So this ultimately led me to this one-page brief, something concise, something consistent, and something very easily recognizable by the doctor, which I fully agree has worked way better than my three to 10 pages that I used to have

Dana Gibbs MD 38:51

Yeah. Yeah. So do you think the difference is between being dismissed because you're asking the wrong questions versus being dismissed because you weren't properly prepared or because the system just isn't set up to answer what it is you've got going on? And I'll give you an example. So somebody walks in and says, "Dr. Google says I have adrenal fatigue, and I need this supplement." Versus, "Hey, Doctor, I have these symptoms and I need your help. I think I might have XYZ, and can we order these labs to make sure that I don't have these things?" think that's a much more nuanced way of approaching it.

Lindsey Perez 39:36

And to answer your question, I think, about the differences in a dismissal in an appointment versus having a more productive conversation, I think is ultimately in the symptom to why pipeline and that story that you tell Doctor. So ultimately, going through different appointments, me just coming, like I mentioned earlier, with very generic symptoms, "Oh, my hair's falling out, thinning. My skin's very dry. I cannot lose weight. I'm tired all the time," Is exactly what I would say. Those don't lead to very productive conversations because that was just met with, "Oh, but your labs are normal.

Dana Gibbs MD 40:13

Yeah

Lindsey Perez 40:14

are normal." So as soon as I made the shift from, "Oh, my hair is thinning. It's been thinning for the past three months. I had this happen in my life about a year ago. My weight has been the s- same since I was nine years old. Nothing's changed in my eating. Nothing's changed in my weight. I would like to understand more about my insulin resistance because of this," that led to more productive conversations. So it's that through line, I think

Dana Gibbs MD 40:42

I think that's really good. So walking in with a little bit of education is, "Look, it could be these five things, and can we do something to help rule those out? Or help me manage this and this, because I think this is part of the problem." Yeah, that's really good. So really... most people don't really think about this, but the doctor deciding how much testing you get is often employed by the same organization that's paying for your test, how do you think that's affecting what's going on in healthcare these days?

Lindsey Perez 41:19

I think it's a huge part of healthcare. I think it's the ultimate root of getting down to issues. Having that barrier is always really rough, but it ultimately I think it ultimately falls back to exactly what we're doing in the education and the advocacy space to make sure every appointment, every lab is intentional That and making it, making the journey as productive and efficient as possible because When you have a year where you don't test your TSH or free T3 or free T4 and you come back a year later and they're all fluctuated and your symptoms are out of whack, that is an unproductive year. As soon as you have that set of labs done and Ultimately having that one and done situation, I think it's more productive than anything, but ultimately it's a barrier. I think it's just another barrier in our healthcare system That makes it a little bit more difficult for accessibility ultimately

Dana Gibbs MD 42:15

Yeah. Yeah, my, my feeling is the doctors are really caught in the middle. A physician who wants to order more testing for you or try a medication that isn't first line, they're not just making a clinical decision, they're potentially creating a big administrative problem for themselves because they're wanting to order something your insurance doesn't allow, so they're actually challenging their employer and saying, "Oh, you're wrong." They could get fired for that. it's really a scary thing that I don't think people think about, and it doesn't make the the physician bad when they say, "Oh your insurance isn't gonna cover that." And you need to be ready to go outside the system to get what you need, and it's really... It's very difficult. All right, so tell us about the tool that you built. What problem are we solving and what does it actually do?

Lindsey Perez 43:07

So this tool is basically a form that anybody can fill out in anticipation of an upcoming appointment. And once the appointment is upcoming, and you come in with this brief that basically has your primary request, has all your symptoms, your current medications, your lab status, you go into your appointment very confident. And exactly what usually happens is a productive conversation between you and your doctor, which is the goal. The goal is to ultimately open the conversation to understanding more about your symptoms, more about your body, and getting s-- jump-started on your journey so that you understand that, no, these symptoms are not normal. You're not supposed to be living with chronic fatigue and hair loss and stagnant weight. These are exact symptoms from your hormones or your insulin resistance or your stress. These are the complexities that I help women figure out. It's a journey, I think, ultimately is what I like to tell everybody because it really is. I, I've been on this journey since I was nine, and ultimately advocating for myself has changed my life, has become more, more confident in myself. And ultimately, I like to spread that as much as I can, and that's exactly what Solaia is. So Solaia is basically the automation tool used to build this one-page brief to prepare you for your upcoming appointment.

Dana Gibbs MD 44:29

Yeah. And how much does that cost the patient?

Lindsey Perez 44:33

now it's $9 a brief

Dana Gibbs MD 44:35

$9.

Lindsey Perez 44:36

Yes

Dana Gibbs MD 44:36

A diagnosis at nine, 16 years of being dismissed, countless appointments, and the thing that finally changes the conversation costs less than a glass of wine? Goodness. Wow. Wow. So I can see that could really change the interaction in the exam room, because really when somebody comes in organized like that, it really signals that they are reliable historian, and it really compresses that intake part of things, 'cause a lot of times the nurse can take that information and put it right into the patient's chart. The doctor, sits there, spends one minute reading it, and boom, they're ready to help you look for your answers. I think that's phenomenal for $9. Oh my gosh

Lindsey Perez 45:23

I think the key through line here between yours and I work is accessibility. That's all we're advocating for, accessibility and just being able to help in any way that we can. And that's ultimately my mission here because we've struggled. We've struggled in a lot of different ways, and we're here to make a difference, and I think that is the ultimate, that's the goal

Dana Gibbs MD 45:44

Yeah. So what's your bigger vision about how you're doing this? You're already using some AI in here to help you organize the data. the, what's the ultimate vision for your company and for what you're doing?

Lindsey Perez 45:57

The ultimate vision is to ultimately have a cycle tracking app that will help your brief get smarter as your appointments keep coming. As we have previously said, hormonal issues are a journey. They're a lifelong journey. As I was diagnosed at nine, my doctor... One of the first things my doctor told me was, "You're gonna have this for life," which is scary to hear. It's scary to hear that I'm gonna have this for life. But keeping an eye on it, having a brief like this, close-knit every appointment, is exactly what the journey to Solaia looks like. So a patient who has been subscribed to Solaia for, let's say, two years now can now go in with the brief, and two years of their history can automatically be uploaded and automatically be be up to date with exactly what they're going through. So they can input exactly what's been going on in their life, how that's affecting their symptoms, and ultimately, their doctor's up to date in that one-page brief. So that is the long-term journey. But for now, I am helping women one-on-one with the brief, getting their stories heard, and spreading

Dana Gibbs MD 46:59

Wow. All right. That is so cool. How can people find you?

Lindsey Perez 47:05

So you can find me at solaia.tech.com. That is where you can find the brief, my story, my email, my number, my LinkedIn. You can find me there. So please

Dana Gibbs MD 47:17

Oh. That's so cool. Okay, solaia.tech.com. I will make sure that ends up in the show notes. And, just one final thing that I wanna say about this topic is that being told that your labs look normal is not the same as being told that you're well. It means the tests that were ordered did not find an answer for you, and that's actually a very different statement, regardless of how insensitive it sometimes comes out of the doctor's mouth, and so told your labs is normal ought to be the first step, not the final step. It's okay, this is a moment when you can say, "Okay, now I need to go dig deeper." And I will tell you, we have wonderful tools now. And, I am not like most doctors who tell you not to Google your symptoms. I think you should Google your symptoms, because sometimes the AI can put it together and say, "Here is a list of the possible things that could be going on." And don't ignore the fact that it could be more than one thing. Like with you, it turns out there's not just Hashimoto's, it's Hashimoto's plus PMOS. and it's entirely possible that there's something else there that you'll find as you go through. So thank you so much, Lindsey, for coming on the podcast. It's been really fun talking to you, and I wish you absolutely the best of luck in your journeys on your way to recovery. And, I hope you'll come back and talk again sometime. I'm really actually very interested in your journey with GLP-1, because I see that as a potential tool for more and more people with Hashimoto's disease. And and yeah, I think it's gonna be a game changer

Lindsey Perez 49:10

Thank you. Thank you so much, Dr. Gibbs. I really appreciate your time. Love your podcast. I-- before this, I took a deep dive into all of your episodes. Very informal-- like very informational and just really complex, and it's exactly the kind of platform that women like us need. So thank you so much for your work and your support. I would love to come back. Absolutely. And yes, sharing the GLP-1 journey, I'm very early on, so I would love to come back whenever

Dana Gibbs MD 49:41

Awesome. Thank you so much for being here. And if you are not already subscribed for the podcast, go ahead and hit that subscribe button. And if you want to do a deeper dive with me, you can go to danagibbsmd.com and click on a discovery call. So I'll see you again next time. Bye-bye

50:05

In previous episodes of this podcast, I have talked about what I think are the ideal ranges for the different labs in the Core 5 thyroid lab set that I use in my practice. But you may be wondering, how can I go from knowing what an ideal set looks like to actually moving mine in the right direction so I can feel better? Everything Lindsey and I just talked about, the labs that don't get ordered, the self-doubt, the years of being told you're fine when you don't feel fine, especially the not knowing where to turn next, is exactly the gap I built my new signature group program, the Thyroid Clarity Checkup, to close. It started as an lab analysis how-to, but it's evolving into a group mentorship program that takes you all the way from not even knowing what labs you need to having the tools to actually become your own health advocate, to get your own numbers back where they should be, get your normal life back. The thyroid disease might be a lifelong journey, but it should be an afterthought, not a defining feature in your health. So if this sounds like something you need, you can sign up for the priority notification list at danagibbsmd.com/checkup. You'll be first to know when I open up the next round of live session. Most of the women who are gonna join me are gonna be there because they're exhausted, and they can't think straight, and nobody around them takes it seriously. Weight can be a part of the picture too, but it's really rarely the whole reason somebody joins. Inside the program, we're gonna start with ordering the exact thyroid labs you need and then how to do that same analysis process that I go through with my one-on-one patients. I call it the Core 5 lab set analysis. This tells you exactly what you need to change, and then we'll look at related pieces that so often get missed alongside Hashimoto's, exactly how to manage thyroid medications to get the best pot of-- possible outcome, untangling thyroid from all the other conditions that go with it, like perimenopause, low iron and ferritin, and then how to eat for PCOS or insulin resis-resistance. The whole picture. You'll go back to your next appointment knowing exactly what steps you need to take. I would love to see you inside this group, so check out danagibbsmd.com/checkup and get on the priority list. 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.