Health Babes Podcast #058: Five Signs Your Thyroid Is Not Functioning Properly

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Intro: (00:03)

Welcome to the Health Babes podcast with Drs. Becky Campbell and Krystal Hohn, where we talk everything health.

Dr. Becky Campbell: (00:14)

Hey guys, welcome to the Health Babes podcast. I am your host, Dr. Becky Campbell, with Dr. Krystal Hohn. In today’s episode, we talk about the five signs your thyroid is not working right. We talk about the testing you should ask your doctor for if you suspect you have a thyroid issue, the optimal lab ranges for thyroid health, and the driving factors of thyroid disease. We talked a little bit about family life, and we answered some listeners’ questions. So let’s get started!

Dr. Becky Campbell: (00:41)

Twenty million people in the United States suffer from thyroid disease, and 60% of them are unaware of it. It’s usually because they don’t really know what the symptoms are or what to look for. So can you imagine if they did know and if their doctors were checking a thorough thyroid panel, which we’re going to go into detail about, what that number would be? Twenty million—it would probably be, what do you think, 40 million?

Dr. Krystal Hohn: (01:09)

I would say a lot more. Yes, exactly. We’re just not checking it. And so much is missed, don’t you think? We see this in practice so much.

Dr. Becky Campbell: (01:16)

Yes, because most people come to us with limited testing. They’ve had a TSH and maybe a T4-free, which doesn’t make any sense because we really know that T3-free is the most usable form of thyroid hormone. We’re going to explain all the different markers of what you need to ask your doctor for and what they mean. And then you’re going to realize how insane that is and that this is limited testing that we’re doing. And if we could only get people to test a full thyroid panel on everybody, I guarantee you that so much more of this would not be missed and people would know ahead of time. This is why we always check for antibodies to the thyroid, so our body can attack the thyroid gland. And that’s the most common form of thyroid disease. It’s where it all starts for most people. So that’s why in our practice we check such a thorough thyroid panel and we look at the antibodies to the thyroid because if you can catch that early before there’s any destruction to the thyroid gland, you may not start to deplete those thyroid hormones.

Dr. Krystal Hohn: (02:24)

And Beck, how many people come to us who have never had their antibodies checked?

Dr. Becky Campbell: (02:28)

Ninety percent.

Dr. Krystal Hohn: (02:29)


Dr. Becky Campbell: (02:30)

Ninety percent. And their doctor doesn’t even listen to them. And people always ask us why, right? And I think, honestly, if you’re going to a general practitioner, maybe they don’t know the thyroid that well. So then they want to send you to an endocrinologist just to have a more thorough thyroid panel. And I think it’s because they don’t really know what to do. Okay, so let’s say you do have antibodies. What do we do? Right?

Dr. Krystal Hohn: (03:02)


Dr. Becky Campbell: (03:03)

Right. So we want to kind of go over all that with you guys today and teach you: What does it mean? What should you do if you have the antibodies high with or without the thyroid hormones showing up yet that they’re off? And then there’s a really interesting fact. People always ask us: Women or men—who has more thyroid disease?

Dr. Krystal Hohn: (03:24)

Yes. And actually, women deal with it five to eight times more likely than men because of all of our hormone fluctuations, pregnancy, the products that we use on our skin, like hormone endocrine disruptors, and so many things us women go through more. We have a lot more fluctuations with our hormones, so we’re more likely to deal with it. And then, with estrogen dominance too—men can deal with estrogen dominance too; I don’t want to leave them out—this can block the uptake of thyroid hormone. So we see a lot of estrogen dominance in the practice with women.

Dr. Becky Campbell: (04:00)

With those products, they create [something] like a chemical estrogen.

Dr. Krystal Hohn: (04:06)

The xenoestrogen.

Dr. Becky Campbell: (04:07)

Yes. So do you want to explain what xenoestrogen is a little bit more?

Dr. Krystal Hohn: (04:12)

It’s basically like a fake estrogen, is what I would like to say it is. It’s in plastics, and a lot of the products we use [that contain] phthalates and parabens. It can cause us to go down really unfavorable pathways in our estrogen metabolism, which can lead to cancer. It can lead to a lot of different things. It’s dangerous, and you just want to make sure you’re limiting these things as much as you can in the products that you use. And it can affect so many things, right?

Dr. Becky Campbell: (04:41)

Yes. And people probably see a lot of us in this functional medicine world talking about using safer products, and I don’t know that people even know what we’re saying. Using makeup, lotions, perfumes, and all that stuff that has chemicals in it can actually raise our estrogen levels or create this xenoestrogen, like Krystal was just saying. That really messes with our own hormone levels because they bind to our estrogen receptors. So this is why you’re seeing a big movement towards clean makeup, clean cleaning products, and plastic water bottles.

Dr. Becky Campbell: (05:24)

It’s so funny because I just moved, so I had these guys here putting in some flooring for me, and I was so annoying. The guy was like, “Can I use your microwave?”—which we don’t even use, really. So I said yes. He had a glass container. I was so excited to see the glass container, but he had a plastic lid, and he put the plastic lid on top of it to microwave it. And I was like, “Wait!” I’m like, “No!” I practically dove across the kitchen. I’m like, “Wait!” He’s like, “What?” I said, “Don’t put the lid on.” He goes, “Why?” I said, “Your plastic is leeching chemicals.” He just looked at me like, “What are you talking about?” And I kind of gave him a little, small, annoying version of the lesson. He was like, “Wow, I did not know that. I had no idea.” I said yes. I said, “Put a paper towel or whatever over it if you don’t want it to go everywhere, but don’t put that plastic lid on. You’re doing so well with the glass because glass does not leech chemicals the way plastic does.” But people just don’t know, and they don’t understand.

Dr. Krystal Hohn: (06:33)

Even with Starbucks cups, right? The plastic lids—it’s gross. You have to be careful, and it’s just not known. We don’t know a lot about this stuff. And the world is just about convenience. So you have to really make these small steps to see some big changes with your hormone health. So we could talk about this all day, can’t we?

Dr. Becky Campbell: (06:57)

Yes, it’s true. And people think we’re being judgmental or just being whatever when we say, “Please don’t wear perfume around me,” or whatever. But it’s really just trying to protect what we know it does to your hormones. And there are a lot of really cool apps and stuff out there now. I love that Think Dirty app, and you can check all of your makeup and your household cleaners and all that stuff, and it gives you a rating and tells you why it gave it that rating. And it goes through all the chemicals to talk about: What is it doing specifically to your body? So if you guys are trying to figure out how to find this out, look at the EWG website, which is the environmental working group, and they have an app, and then the Think Dirty app. We like those.

Dr. Krystal Hohn: (07:46)

And I always say to people: If you run out of something, replace it with something better. Don’t feel like you have to go through your entire house and throw everything out. Not everybody can afford to do that.

Dr. Becky Campbell: (07:59)

It’s not feasible for most people.

Dr. Krystal Hohn: (08:00)


Dr. Becky Campbell: (08:00)

Yes. Just do one thing at a time, the best you can do. The small things add up over time, for sure.

Dr. Krystal Hohn: (08:08)

It does. It does. So why don’t we go into what the thyroid gland is, Beck?

Dr. Becky Campbell: (08:13)

Yes. So the thyroid gland is this little butterfly-shaped gland right in the front of your throat. [laughing] So anyway, it’s the little gland right here in the front of your throat. If you’re not watching, you can feel it; it’s right in front of your throat. You can just touch it, and most people know where it is. And it produces thyroid hormone. Thyroid hormone, which a lot of people don’t realize, is in pretty much every cell in your body.

Dr. Krystal Hohn: (08:40)


Dr. Becky Campbell: (08:41)

Yes. So it’s directly or indirectly affecting pretty much every function in the body. Some examples of that: Heart rate, your breathing, your weight, which we know that—I think everyone at this point probably knows that because it’s one of the biggest complaints that we see—and we’re going to get into the signs and symptoms soon.

Dr. Krystal Hohn: (09:03)

Menstrual cycles, right?

Dr. Becky Campbell: (09:04)

Right. And body temperature—it’s like our little metabolism control center of the body. So this is a really good way to understand what the thyroid is doing. The thyroid controls your metabolism. There’s hyperthyroid, which would indicate too much thyroid hormone, and then there’s hypothyroid, which would indicate too little thyroid hormone. When we look at our main thyroid hormones, we have T4, which is our inactive form of thyroid hormone, and T3, which is our most usable, active form of thyroid hormone. T4 has to be converted into T3 in the body to be used.

Dr. Becky Campbell: (09:46)

When you’re looking at your labs—we’re going to go into exactly what your labs should look like—you’re going to see that with hypothyroidism, you typically have high thyroid stimulating hormones. What that means is… And I know so many people get TSH tested, but they don’t actually know what it means. So your pituitary gland is this little gland that sits inside your brain, and it’s kind of the gland that tells all the other glands what to do with hormone production. Your pituitary gland sends a signal to your thyroid gland, and that’s what the thyroid stimulating hormone, or TSH, is. And that tells your body whether you’re making too much or too little thyroid hormone. If your T4 and T3—those thyroid hormones we were talking about—are too low, then your TSH is going to be high because you need a lot of stimulation to make more T4 and T3. So it’s kind of confusing. A high TSH, low T3 and T4 is going to be hypothyroid—too little thyroid hormone.

Dr. Becky Campbell: (10:58)

On the other hand, we have hyperthyroid, which is going to be a low TSH because your T4 and your T3 are high, so you don’t need to stimulate your thyroid to make more thyroid hormone. So, low TSH, high T3 and T4. So we’re going to talk about those two today. And then with those, there are autoimmune diseases that go with each. Now, not everybody who has hyperthyroid or hypothyroid has an autoimmune disease. But with hypothyroid, the number one cause of hypothyroidism is something called Hashimoto’s disease. Hashimoto’s disease is the autoimmune disease where your body attacks your thyroid hormone, therefore depleting how much thyroid hormone you’re making. It’s really more of an immune system issue than an actual thyroid issue. And then with hyperthyroid, it’s not as common as hypothyroid, and the autoimmune disease is not as common as Hashimoto’s. But the autoimmune disease for hyperthyroid would be Graves’ disease. The same thing, [there is an] autoimmune component, but it’s making you produce too much thyroid hormone.

Dr. Krystal Hohn: (12:06)

It’s brutal. Graves’ is brutal, isn’t it? We don’t see it as commonly, but it’s definitely really hard to deal with.

Dr. Becky Campbell: (12:13)

It is. It is. And a lot of these people end up having iodine treatments. Basically, what’s happening with that is that your doctor’s putting you into hypothyroidism and then putting you on medication for hypothyroidism after you’ve kind of shut down your thyroid. Sometimes it’s necessary. We’re not here to say, “Never do anything that someone tells you,” as far as that goes. But really, we know that the immune system lies in the gut. About 70% of it lies in the gut. So we look at: How can we support the immune system first before destroying something so important as the thyroid?

Dr. Krystal Hohn: (12:59)

So let’s get into some of the signs of [inaudible].

Dr. Becky Campbell: (13:03)

Here are five signs that your thyroid isn’t working right. So if you think you may have a thyroid issue but don’t know what to look for… And there are not just five, to be clear.

Dr. Krystal Hohn: (13:13)

No. We picked five.

Dr. Becky Campbell: (13:16)

But we picked the top five that we see the most. So remember, we talked about the thyroid being that metabolism-control system, right? Metabolism is going to be either sped up or slowed down. With hypothyroidism—those low thyroid hormones—everything is slowed down. With hyperthyroidism, everything speeds up. So this is why you’re going to see completely opposite things happening, depending on what you have going on. The number one sign that your thyroid isn’t working properly would be a change in weight. Now, that can be linked to other things, but when we’re talking about the thyroid, typically what you see with hypothyroidism is weight gain because you’re slowing down that metabolism. So you’re not burning as many calories and all that. So you’re going to start to put on weight. Just to keep in mind, you do not have to have all these symptoms or any symptoms to have this.

Dr. Krystal Hohn: (14:17)

Because we see a lot of patients too with hypothyroidism who don’t deal a lot with weight gain. I see that a lot. But still, it’s just to keep in mind that this is a very common one with [inaudible].

Dr. Becky Campbell: (14:28)

Yes. This is probably the one we see the most. So, weight gain for hypothyroidism. With hyperthyroidism, you are amped up, so your metabolism is burning, burning, burning, and you’re going to tend to have weight loss. Now, have we seen people with weight gain with hyperthyroidism? Absolutely. But it’s not that common.

Dr. Krystal Hohn: (14:48)

Yes. And usually, especially with Graves’, you see someone with just an unrelenting appetite. Don’t you see that? I know that’s happened, even with my father-in-law. And he would be happy to share his story; that’s why I’m sharing it.

Dr. Becky Campbell: (15:00)

And they burn it off, though.

Dr. Krystal Hohn: (15:03)

Yes, they do. And it sounds appealing, but it is not. It is not.

Dr. Becky Campbell: (15:09)

It’s not. And it comes down to the anxiety that comes along with that, which I’m going to get to in a minute.

Dr. Krystal Hohn: (15:15)

Yes. Okay, so let’s go on to changes in digestion.

Dr. Becky Campbell: (15:18)

Yes, so symptom number two, or sign number two, would be changes in digestion. Constipation—there’s something called transit time with how fast your food digests and kind of comes out to be poop. That slows down when you have hypothyroidism, so a lot of people with hypothyroidism are constipated, right? Don’t we see that a lot?

Dr. Krystal Hohn: (15:44)

Oh yes. Slow motility, really bad constipation. And then the opposite effect with hyper[thyroid] would be a really fast transit time, so a lot of diarrhea and things like that.

Dr. Becky Campbell: (15:55)

Yes. Watery stools, diarrhea. They’re going to the bathroom all the time. They’re telling us, “I can’t plan to go anywhere because I don’t know when I’m going to have diarrhea,” which is not fun at all.

Dr. Krystal Hohn: (16:07)

Not at all.

Dr. Becky Campbell: (16:07)

And then I think a universal sign on both ends is hair loss.

Dr. Krystal Hohn: (16:12)

Yes. And it’s hard, too, with hair loss because it’s such a symptom of so many underlying hormonal imbalances. But for the most part, we do see a lot of hair loss with thyroid dysfunction, and not just on the head. We see a lot of hair loss on the outer third of the eye—with your eyebrows. We see a lot of that. So just keep that in mind if you’re struggling with that and look into the thyroid, for sure.

Dr. Becky Campbell: (16:37)

Wouldn’t it be nice if we lost the hair on our chin, armpits, [inaudible]?

Dr. Krystal Hohn: (16:43)

Right? Just, just lose it all there, please, and forget the face and hair where we need it! Oh my gosh, isn’t that the truth?

Dr. Becky Campbell: (16:53)

Okay. So sign number four would be energy levels. So if everything’s slowing down, you’re going to be more tired. Our biggest complaint with energy that we see with hypothyroidism is feeling like you did not get a full night’s sleep. We actually have a questionnaire that we have everyone fill out when they become a patient of ours. We see it all the time, right? You get seven hours plus of sleep [but] feel like you’ve had no sleep.

Dr. Krystal Hohn: (17:26)

So [there’s] a lot of fatigue with hypo[thyroid]. And then with hyper[thyroid] you see a lot of adrenaline and so much energy, but it’s almost anxiety energy.

Dr. Becky Campbell: (17:35)

It’s that wired, tired feeling. So they’re still a little tired, but they’re so anxious, amped up, and feeling nervous. That nervous energy you see a lot with hyperthyroidism.

Dr. Krystal Hohn: (17:49)

That’s why you also see so many headaches with hyper[thyroid]. There’s so much adrenaline. You can see a lot of that with it. It’s hard. Really hard to—

Dr. Becky Campbell: (18:00)

And when your body is so anxious, think about what that’s doing to your muscles and the tension in your body. It’s not good. I think if I were to compare the two, people with hyperthyroidism probably feel worse. Don’t you think?

Dr. Krystal Hohn: (18:16)

I think so because it’s just so [much] more extreme, and it’s just so hard to deal with those symptoms. I mean, they’re not sleeping at all.

Dr. Becky Campbell: (18:25)

Nope. They’re not sleeping. They’re really amped up. Think about drinking seven cups of coffee, and that’s kind of how they feel—not fun. And then number five is temperature, because the thyroid plays a huge role in our temperature control. [If you’re] one of those people who always has cold feet and hands, or you are with your partner at home and you are freezing in a snowsuit practically, and they’re sweating—that’s a typical sign of hypothyroid, or too little thyroid hormone. And then with hyperthyroidism, they’re pretty hot, because everything is so up and they’re so amped up, they’re sweating a lot of the time. And a huge thing: Let’s say you’re already diagnosed with hypothyroidism, you’re taking thyroid medication, and you start to feel [your] heart racing, palpitations, or sweating. Most of the time, that’s because you’re on too high of a dose of your thyroid medication. So we look for that a lot, and then we’ll test our patients, and we’ll see: “Oh, well, your thyroid hormones are now going high; you’ve got to reduce this dose.” That’s if they’re on hormone.

Dr. Krystal Hohn: (19:44)

And they may need to increase it depending on what their numbers say and the symptoms they’re experiencing. So it definitely goes both ways. When you’re on medication, especially when you’re working with doctors or even functional medicine doctors, you may need to change the dosage. You need to keep up on that. It’s important to always manage and look at your thyroid levels. And Beck, how many times do we hear this too? “My doctor just wants to check it once a year. I’ve been on the same dose for” how long, and they’re not keeping up with it either. And I am not downing doctors. I mean, there are a lot of wonderful doctors out there, but there are so many other ways you can take your health into your own hands and get your thyroid levels checked. There are a lot of great companies. You can find a doctor who’s willing to do it. So that’s just so important. Don’t we see that so much [inaudible]?

Dr. Becky Campbell: (20:33)

Yes. Because thyroid hormones fluctuate so much, and when it comes to antibody levels, they also fluctuate a lot, you can’t chase labs. Unfortunately, with thyroid, you cannot chase the labs and adjust all the time, because sometimes you’re just dumping a bunch of thyroid hormone and sometimes you’re not. You have to really work with someone who understands the thyroid so well. And I have Hashimoto’s disease, and this is what got me into thyroid. Everyone knows me for [my] histamine [issues]. We work with so many thyroid patients. My first book is on thyroid disease in general. So you have to really work with someone who knows what else is going to be driving your thyroid issue, which we’re going to get to in a second. But it’s not just about the medication; it’s not about chasing numbers, for sure.

Dr. Krystal Hohn: (21:29)

No. Not at all. Yes. So many people are going to want to know this: What should we be running in a panel? What should we be asking our doctors for? What’s important? Let’s list them out. Yes, let’s do that.

Dr. Becky Campbell: (21:45)

So one thing I want you guys to know is that in the show notes I have created—and I created this a couple of years ago, but it stands true now—what’s called the Ultimate Thyroid Guide. And what it is is that it tells you all the tests to ask your doctor for, breaks down what each marker means, and what the optimal range for each marker is. But I’m going to still go through that with you now.

Dr. Krystal Hohn: (22:08)

Awesome. It’s a great PDF, you guys. You can just pull it up whenever you need it. It’s very easy to understand, because this stuff can get confusing.

Dr. Becky Campbell: (22:16)

So the number one thing, and everyone’s going to test this, is going to be thyroid stimulating hormone. So that’s that hormone we talked about—your body’s basically signaling your thyroid to make more or less thyroid hormone. And then you’re going to do T4, [which] is the hormone that our thyroid primarily makes before it’s converted into T3. So we want to see what the total T4 looks like, which is the T4 that’s bound to a protein—proteins are kind of our little carrier mechanisms through the body—and then T4-free, which would be the unbound version of the T4 hormone. And then we want to see the T3 total. Again, that’s going to be the bound version of T3. And then we want to look at the free version of T3, which is the most usable form of thyroid hormone in the body. And then we want to look at reverse T3.

Dr. Becky Campbell: (23:05)

Reverse T3 is really important. Let’s say you have T3 total; it’s going to go down either the T3 free pathway or the reverse T3 pathway. And it should go down a little bit of both. When it goes down too much of the reverse T3 pathway, that’s your body’s way of telling you: “I’m tired. I need rest. I’m inflamed. I’ve had enough.” We’re going to get to listeners’ questions in a little bit. Someone asked [about] the optimal ranges, so we’ll go through each range for you. But when the reverse T3 is too high, that is a big signal. We test this on everybody, and we retest it on everybody. It’s a really good indicator of: Do you need more rest? Are you inflamed? And then, are you getting better?

Dr. Krystal Hohn: (24:00)

Stress is a big driver.

Dr. Becky Campbell: (24:01)

Yes, stress—huge!

Dr. Krystal Hohn: (24:03)

We call that the ‘hibernation hormone.’ It can just kind of sit there. If you’re chronically stressed, you’re just going to feel awful. It can give you a lot of hypothyroid symptoms if you have really high reverse T3. So you want to work on that stress. Is stress not the driver of so many things? And everybody wants to roll their eyes at it because we all have stress. We’re all trying to manage the big guy, right? So it’s so important to do that. But I didn’t mean to go off on a tangent.

Dr. Becky Campbell: (24:33)

No, that’s okay. And I think with stress, it’s really important to understand. We know it’s not easy to manage stress. I think people get mad when you say manage stress, and then you leave it at that. So we don’t just do that. We actually give our patients exact instructions on how to manage stress. And everyone’s different in what’s causing their stress. So we listen to where it’s coming from, and then we give them the best instructions we can to manage it. And we’re working on it ourselves. I mean, it’s a constant in this world.

Dr. Krystal Hohn: (25:06)

Yes. We all have it. We just have to learn and give our bodies the tools necessary to help manage it and adapt better because you can’t take all stress away. If someone has a really stressful job, you need to work—you can’t take your job away—but you’ve got to manage stress.

Dr. Becky Campbell: (25:24)

And there’s the good stress, the eustress—that would be like working out and certain things like that—where you’re putting your body into a little bit of stress, but it’s ultimately for a goal. It’s a good thing for your body. And then there’s the bad type of stress. So we’re trying to get rid of the bad type.

Dr. Krystal Hohn: (25:43)

The bad type.

Dr. Becky Campbell: (25:44)

Or how your brain sees the bad type, right? The perceived stress.

Dr. Krystal Hohn: (25:50)

For sure.

Dr. Becky Campbell: (25:51)

So then the antibodies are thyroid peroxidase antibodies. That’s the main marker that people use to diagnose Hashimoto’s disease. Again, that is the autoimmune disease that basically signals your body. So in autoimmune disease, your body targets a certain area, and with Hashimoto’s, it’s targeting your thyroid gland, and your body’s going to start attacking your thyroid gland. The more that happens, [the more] you start to deplete those thyroid hormones. That is the number-one cause of hypothyroidism. I’ve seen that anywhere from 90 to 96% of hypothyroidism is caused by Hashimoto’s disease.

Dr. Krystal Hohn: (26:35)

By Hashimoto’s. Yes. Yes.

Dr. Becky Campbell: (26:37)

And also, just so you know, this is really important: Not everybody is going to show the antibodies on blood work. I don’t, and I have Hashimoto’s. The only way I knew I had Hashimoto’s was after getting an ultrasound—it’s looking at the echotexture, which is basically like the hills and valleys, or the smooth texture, of your thyroid gland—so that’s how you know in some people. About 20% of people do not show the antibodies, and they still have Hashimoto’s disease.

Dr. Krystal Hohn: (27:11)

And how many times do patients do a full thyroid panel without antibodies and everything looks good? Maybe they didn’t have an ultrasound, or maybe they didn’t check their antibodies, and the antibodies are high. It hasn’t attacked the thyroid yet. So then we know this is more of an immune system issue. So there are so many things we can be doing to support that and get ahead of it now. And we’ll get into that a little bit more about some things we can do to support the thyroid and all that.

Dr. Becky Campbell: (27:43)

And this is why it’s so frustrating when people don’t have those tested, because we have tested so many people who have high antibodies—the thyroid peroxidase antibodies—and they may have high thyroglobulin antibodies, not always, and they don’t have a disruption in their thyroid hormone T4, T3, or TSH levels. So we know, “Okay, this is coming,” basically, but it hasn’t affected the thyroid yet to the point where it’s showing up on labs. And “let’s start doing” these A, B, and C “to stop that from happening or to slow down the process at least.” And it can really prevent a lot of people from having to be medicated, getting symptomatic, or whatever it is. And I just want to say that thyroid medication is not a bad thing.

Dr. Krystal Hohn: (28:34)


Dr. Becky Campbell: (28:35)

It’s one of the most benign, I guess.

Dr. Krystal Hohn: (28:38)

Yes. It doesn’t give you a lot of side effects, I don’t feel. No. It’s so important if you really, really need it. And there’s a time and a place for it, so I always make sure I stress that to our patients when it comes—

Dr. Becky Campbell: (28:53)

Yes, because people have that guilt complex when it comes to medication, and it’s worse to not have enough thyroid hormone or have too much than it is to take medication. But we always want to try to avoid it if possible, so we work with both.

Dr. Krystal Hohn: (29:09)

Exactly. Go ahead.

Dr. Becky Campbell: (29:11)

I was just going to say that the last marker that we really look at—and this is only if you have hyperthyroidism and your antibodies are positive—is something called TSI. That would let you know if you have Graves’ disease, which is the autoimmune component of hyperthyroidism, or not.

Dr. Krystal Hohn: (29:32)


Dr. Becky Campbell: (29:33)

Okay. So let’s talk about what we do with our patients. We’ll kind of walk you through what a functional medicine doctor should be doing and what we do to help people figure out… because there’s always a driver. And in my book—this is my thyroid book, The 30-Day Thyroid Reset Plan—it disarms the seven hidden triggers that are keeping you sick. And there are more than seven, but these were kind of the big ones. First and foremost, we take a very detailed history. We want to know what you’re eating, how you’re sleeping, and all that stuff—any history you’ve had. How was your birth? Were you on antibiotics when you were younger? Was your mom on antibiotics when you were in her belly? All of this stuff really matters.

Dr. Krystal Hohn: (30:31)

Are you on birth control? What medications are you taking?

Dr. Becky Campbell: (30:32)

Yes. Yes. Exactly. So the first thing that we do with everyone is look at diet, because diet plays a huge, huge role. And there’s actually a study—there are plenty of studies; I’m only telling you one—called “The importance of nutritional factors and dietary management of Hashimoto’s Thyroiditis”. If you’re going to a doctor at this point who is telling you that diet does not matter when it comes to thyroid disease, I would strongly recommend you go to a different one because they’re not paying attention to even the literature at this point. When there weren’t any studies on this, that might have been an excuse. But now there are, and there are plenty. This specific study talks about how there’s a big genetic component to thyroid disease, which we know, especially with the autoimmune parts of thyroid disease.

Dr. Becky Campbell: (31:31)

But in this specific study, they talked about… And I loved this because this is not even talked about much. They specified that stress, toxins, and basically the health of your gut—the microbiota, which is basically our little gut community… So [the study was] looking at dysbiosis—meaning we have too much bad bacteria compared to good bacteria, a yeast overgrowth, or parasites—[and how] whatever’s going on in there plays a big role in this. And remember, we talked about how 70% of your immune system lies in your gut. So this is a really, really big factor in what’s going on with your thyroid, or any autoimmune disease, for that matter. And then under or overnutrition—a lot of people we work with come to us undereating because they’re told they have to eat 1200 calories a day because they’re gaining weight and they want to lose it. And they’re really damaging their hormones. All of them.

Dr. Krystal Hohn: (32:28)

Not just thyroid. Exactly. We see so much undereating. And your thyroid gets impacted by that. You have to be so careful of that.

Dr. Becky Campbell: (32:36)


Dr. Krystal Hohn: (32:37)

And overeating, right?

Dr. Becky Campbell: (32:38)

Yes. Or eating the wrong foods, right? They also acknowledge in the study how casein from dairy and then gluten can be an issue for thyroid disease. Yes. I think some people, not all, get upset about the ‘don’t eat gluten’ movement. And there is an actual scientific explanation behind this, especially when it comes to thyroid disease. So gluten’s molecular makeup is very similar to [that of] the thyroid cells—the molecular makeup of the thyroid. So when you have thyroid disease and when you eat gluten, your body sees that they’re both very similar. What happens is that it starts to attack your thyroid gland even more when you’re consuming gluten, because it’s called molecular mimicry. Your thyroid glands are basically mimicking the makeup of each other. So your body thinks it’s attacking a foreign invader, which would be gluten, and it starts attacking the thyroid.

Dr. Becky Campbell: (33:45)

And this can also happen with dairy, with the casein in the dairy. So this is why, if you’re going to do anything for your thyroid, the number one thing I would say is: Remove gluten, and at least for some people, dairy. Not everybody, right? We’re much more concerned about the gluten. So yes, they acknowledge that in the study, and there are other studies that acknowledge this. So the next time your doctor wants to tell you that this is not a real thing, there’s a website called PubMed, and that’s where you can find peer-reviewed research. So basically, they tested things out with different people, got an outcome, and explain the whole thing to you. So you might want to print out some of those and bring them to your doctor and let them know that you know. [laughing]

Dr. Krystal Hohn: (34:40)

They’re pretty easy to understand and get through, too. If you really are a research person, it’s a great avenue to go [down].

Dr. Becky Campbell: (34:47)

And if you’re not, just read the conclusion.

Dr. Krystal Hohn: (34:52)

[laughing] And if you can’t read that really well, just race on down,

Dr. Becky Campbell: (34:57)

But also, be careful [about] who is doing the research if they have an agenda. You know what I mean? So let’s say that big thing that we know about happened years ago with the sugar industry. They were funding all these research papers saying that fat was bad for you because the sugar industry was funding them. They were paying scientists to basically lie. You have to just be careful. So those are things to look at when you’re looking at peer-reviewed research. Make sure that the person doing the study does not have anything to gain. So do you want to walk us through: What do we do with each patient besides diet?

Dr. Krystal Hohn: (35:36)

Yes. For sure. So first and foremost, especially with the thyroid or any hormone, and really with anything, you want to support your amazing detox pathways, especially the liver. And if you think about it, our amazing pathways are constantly working for us. Our skin—we need to make sure we’re going to the bathroom and urinating regularly, so drinking lots of water—our kidneys, our liver—all these areas are constantly working for us.

Dr. Becky Campbell: (36:08)

But go a little deeper. What are they doing? What does detox mean?

Dr. Krystal Hohn: (36:13)

Yes. So all of these things that we’re exposed to, like chemicals, environmental toxins, and the stress that we’re under, we need to be able to eliminate a lot of these things. And we excrete them through these processes. We really want to support the liver. So, we’re always starting with supporting the liver with patients, especially with the thyroid, because a lot of that T4 to T3 conversion happens in the liver. So we always do a lot of [things like] like gentle castor oil packs, with patients. Get on really good liver support. There are so many different types of liver support, but we absolutely love working with medicinal mushrooms, NAC, and things like that. We love our Liver Love.

Dr. Becky Campbell: (36:59)

Yes. We have a product called Liver Love, and it has N-acetyl cysteine, milk thistle, and medicinal mushrooms in it, which are not only supporting your detox pathways but also your immune system with those mushrooms.

Dr. Krystal Hohn: (37:10)

Exactly. Right. There’s so much. But just by sticking with supporting the liver with thyroid, it’s so important to start this process, especially before we start working on the gut because we do a lot of gut testing with our patients. So when I say gut testing, [I mean] doing [something] like GI-MAP testing or even checking for SIBO with a lot of patients.

Dr. Becky Campbell: (37:33)

Which is what?

Dr. Krystal Hohn: (37:34)

A SIBO breath test.

Dr. Krystal Hohn: (37:36)

What is SIBO?

Dr. Krystal Hohn: (37:38)

SIBO is small intestinal bacterial overgrowth. We’ll be checking that with a lot of patients or doing a GI-MAP test looking for H. pylori bacteria, opportunistic bacteria, parasites, and candida—all of these things can really also hinder that T4 to T3 conversion in the gut. So we want to make sure we’re looking at that. And with gut health, with everything, you want to be metabolizing your hormones efficiently. This doesn’t just have to do with thyroid health. Gut health is responsible for so much of our hormone metabolism. So we’re not only working on the thyroid; we’re working on so many other things when it comes to working on the gut.

Dr. Krystal Hohn: (38:21)

And then, don’t forget, we need to be absorbing a lot of the nutrients from our foods. A lot of the time, patients aren’t absorbing well. So when you’re working on your gut, you’re also working on absorption. And then, of course, we do a lot of hormone testing. We work a lot with the DUTCH Test, which looks at the hypothalamic-pituitary-adrenal axis. And the thyroid sits on that same axis. So you want to make sure you’re looking at your estrogen, your testosterone, your progesterone, your DHEA, and your cortisol. So it’s also not just looking at these markers and bloodwork—it’s not just a snapshot—it’s looking at how you’re metabolizing them. So it’s giving you a really good picture of what your body is doing. Yes. And then we do a lot of bloodwork, right? You want to get into bloodwork?

Dr. Becky Campbell: (39:11)

Yes. So we look at lipid panels—that’s cholesterol and triglycerides. Cholesterol can tell you a lot about how the thyroid is working. A lot of people with thyroid issues will have high total cholesterol and a high low-density lipid profile. So you’ll know it’s not really your cholesterol; it really has to do with your thyroid, if that’s kind of the picture that you’re seeing. And then with triglycerides, which are part of the lipid panel, we’re able to connect that to heart health and also insulin resistance—so, blood sugar regulation, which is really important. And then we look to see how well your body is methylating. Methylation is a very complicated process, but one of the main things is: How well do you detox? How well do you push the toxins out? is what we’re saying. And that’s when she was referring to the pathway. She’s talking about [how] we use pathways to push toxins in our bodies out of our bodies. We use pathways to push excess hormone out of our bodies. So we look at a marker called homocysteine, and that tells us: Do you methylate well or not? And then we look to see: What is the liver doing? What are the kidneys doing? And one thing to know is that when you’re looking at liver function, most people have a little bit of a sluggish liver function if they’re living in this world because we’re exposed—

Dr. Krystal Hohn: (40:45)

Being overburdened. You have to work at that.

Dr. Becky Campbell: (40:49)

Yes. We’re exposed to so many chemicals, environmental toxins, and everything, and everything has to be put through the liver. So, you do not have high liver enzymes to have an issue with your liver. If your liver enzymes are high, that is a really big warning sign. We like to look at that. We like to see what your red and white blood cells look like. Do you have infections that can kind of lead us to that? Are you anemic? In other words, are you [having] iron deficiency anemia or B vitamin deficiency anemia? And then a full thyroid panel. So we look at a lot of stuff. We don’t do the hormones on blood, typically.

Dr. Becky Campbell: (41:34)

We may do some hormones on blood that are not included in the DUTCH test. We love the DUTCH test. They’re looking at our sex hormones—which are primarily produced by our ovaries—but also our adrenal glands, [which] do help make those sex hormones. And then hormones like DHEA and cortisol—cortisol is your stress hormone—those are adrenal hormones. So we’re looking at pretty much a lot. As much as you can, really, upfront. And then, if people need more, which they typically don’t, we typically run those tests. And that’s all it takes. But if they are not getting better within a certain amount of time, then we’ll start looking at chronic viruses, heavy metals, mold, and stuff like that.

Dr. Krystal Hohn: (42:23)

We see a lot of changes with those tests, especially when it comes to supporting the thyroid, for sure.

Dr. Becky Campbell: (42:27)

Yes. Oh, yes. And some people can take glandular thyroid supplements and do really well on them without having to take thyroid medications, and then some people do. Either one is fine. So, we decide who’s a good candidate for what and what support would be best for them. And we like to work with their original doctor if they have a diagnosis already so that we’re all on the same page.

Dr. Krystal Hohn: (42:54)

Exactly. It’s important to have a team when you’re working on this, for sure. Let’s talk about some of the nutrients to help support the thyroid.

Dr. Becky Campbell: (43:03)

Yes. So I’m sure most people probably know [about] selenium. When you hear selenium, I think at this point, if you know anything about thyroid health, you would relate it to the thyroid. So it’s really important for that conversion of T4 to T3. And we’ve seen some issues where people don’t necessarily have hypothyroidism but just have a conversion issue, so their T3 may be low because they’re not converting enough T4 to T3. That conversion happens in the liver, the gut, and some other areas of the body, so that’s why we’re looking at all that stuff. But selenium is really good at helping convert T4 to T3.

Dr. Krystal Hohn: (43:45)

And you want to make sure you’re getting in selenium too, if you’re getting in iodine. That’s important.

Dr. Becky Campbell: (43:50)

Yes. There are studies—and when I wrote my book, there was a study that I found; I think there are more now—that show how selenium really impacts the inflammatory activity of autoimmune disease. So basically, if you take selenium, it can really reduce the inflammation, which can actually help reduce the damage to the thyroid in some cases. So it’s really important to take it. So that leads to the second nutrient, which is iodine. You have to be careful with iodine; it’s a little bit of a double-edged sword. It’s extremely important for thyroid hormone synthesis, but it needs to be taken with selenium. You don’t want to just take a bunch of iodine for most people because, like I said, about 90 to 96% of people have the inflammatory autoimmune [disease] Hashimoto’s disease. And sometimes iodine can actually make your thyroid more inflamed.

Dr. Krystal Hohn: (44:48)

It can. We’ve seen this, especially with patients who’ve come to us and are taking loads of iodine. Their bodies do not need loads of iodine. Let me stress that.

Dr. Becky Campbell: (45:01)

And no selenium with it to kind of counteract.

Dr. Krystal Hohn: (45:06)

Beck, tell about that patient with the goiter.

Dr. Becky Campbell: (45:09)

We had a patient who came to us. She was on high dose—it’s a supplement called Iodoral. She was on that supplement, which I’m not saying is a bad supplement, but for her it was. Her doctor put her on that for her thyroid. I could see that her neck was like this, right? So we did a urine test for iodine, and she was overloaded—I mean, completely overloaded. So we took her off the iodine, and it got better on its own, luckily. But it’s not the case for everybody, so you do have to be careful. We do have a thyroid supplement that’s a blend of all the nutrients you need. It’s called Ultimate Thyroid Support. But if you want to do it with food, you can do selenium. You can eat two Brazil nuts a day, and that is your selenium intake needed. And then you could take a couple of kelp flakes—kelp is a form of iodine. And the flakes are good because you can really low-dose it. So you could do that. And I do talk about that in my book.

Dr. Krystal Hohn: (46:16)

Seaweed snacks are good too. They’re yummy, if you like that kind of weird—

Dr. Becky Campbell: (46:20)

Yes, I like them. I think they’re good. Seaweed, is what she said. Yes, I think they’re really good.

Dr. Krystal Hohn: (46:25)

The lime flavor is good.

Dr. Becky Campbell: (46:30)

Some people might think they’re completely weird. I remember my ex-husband thought they were disgusting, but I was like, “These are great!”

Dr. Krystal Hohn: (46:42)

Another nutrient that’s really important, especially for autoimmune [diseases], is vitamin D, right? Ninety percent of thyroid disease is autoimmune. So you want to make sure your vitamin D levels are good. And you want to make sure it has K2 in it. And make sure you don’t have any issues with clotting, of course, with K2. But yes, vitamin D is so important, not only for our immune system but for so many hormones.

Dr. Becky Campbell: (47:07)

Yes. And K2 helps the vitamin D get better absorbed. Sometimes calcium and D can calcify in the soft tissue, so you want to do the K2 with it to help it kind of move out of there and get absorbed in the places that it’s needed. Again, K2 can be an issue if you have a blood clotting disorder, so always ask your doctor about that before just taking it. So some people have to take D without the K2.

Dr. Krystal Hohn: (47:32)

Talk a little bit about iron too, Beck.

Dr. Becky Campbell: (47:34)

Yes, so iron. The thyroid peroxidase is what we’re looking for with the antibodies, but it actually plays a role in our thyroid, which is important. And that’s why you don’t want to have antibodies against it, killing it. So if you don’t have enough iron, you can reduce that thyroid peroxidase activity in the body. So you don’t want to ever assume with iron. You would want to run a full iron panel with ferritin, which is the stored form of iron. I think it’s the most important iron marker, don’t you?

Dr. Krystal Hohn: (48:08)

For sure. And I don’t feel it’s checked that much. Do you?

Dr. Becky Campbell: (48:10)

No. And so again, that’s why there are a lot of versions of minerals and multivitamins that say ‘without iron,’ because some people are storing too much iron, and you never want to take iron—ever—without having it checked.

Dr. Krystal Hohn: (48:26)

No, ever, because we see a lot of iron overload in the practice, and this can damage the hypothalamus and many other things.

Dr. Becky Campbell: (48:34)

The hypothalamus is that little gland where all hormone production pretty much starts, so we don’t want to damage that. This is why we always test and never guess when it comes to this kind of stuff. I think something like selenium is something you don’t have to test for. But when it comes to even vitamin D, some people have too much. And for some people with thyroid disease, it can be harder to absorb vitamin D. So you really want to know. And that way, you’ll know how much to take, right?

Dr. Krystal Hohn: (49:05)

For sure.

Dr. Becky Campbell: (49:06)

Because it can be a big vitamin D deficiency. Like Krystal said, with autoimmune disease being the biggest cause of thyroid disease, vitamin D is very good at supporting the immune system.

Dr. Krystal Hohn: (49:18)

Yes. Yes. It’s so important for so many things. But you just don’t want to blindly supplement with some of these big guys like vitamin D, iron, or even copper—you’ve got to be careful with that too, especially when it comes to the thyroid. We even see a lot of copper toxicity in the practice.

Dr. Becky Campbell: (49:35)

Yes. And we see that with a lot of hormonal birth control. It drives us copper up. Copper toxicity is a real thing. It can make people have a lot of emotional and mental disorders—kind of drive that—[or] make it worse. Pure Encapsulations makes a good mineral mix, and it’s called Mineral 650, but they have the iron- and copper-free one, because those are two things you should never take without knowing.

Dr. Krystal Hohn: (50:10)

Yes. I know I love that. That’s great. So let’s talk about life a little bit, Beck. What do you think?

Dr. Becky Campbell: (50:16)

Yes. And then we’ll get to some Instagram questions. So we’re not done with the thyroid, but yes. So summer’s here. We have kids.

Dr. Krystal Hohn: (50:27)

My kids got out of school yesterday; we’re all so pumped about it. But of course, we’ve got to start juggling everything with work. They’re going to be at home with me when I see patients. But they’re so good, so they’ll be great. We’re excited. I’m ready for summer. I live in Michigan, for people who are listening. So these three months that we get of beautiful weather, I am just soaking it up. That’s what we’re going to be doing. A lot of lake time, a lot of tubing, skiing—all the things.

Dr. Becky Campbell: (50:56)

Yes. And I live in Florida, which is completely opposite.

Dr. Krystal Hohn: (51:00)

Beautiful Florida!

Dr. Becky Campbell: (51:01)

Well, actually, summer is the worst time of the year as far as weather goes, because it’s kind of like when you walk outside, you’re walking into a sauna. And your sunglasses immediately fog up because the humidity is so high. So we kind of treat summer the way that you guys treat winter, where we stay inside more. Or we’re either in the pool, at the beach, or inside because it’s so hot. And for you guys, it’s like: “We’re free. We get out of this cold weather, and we can do so much,” which is why I might be coming up to Michigan at some point.

Dr. Krystal Hohn: (51:34)

Oh yes, for sure. You guys, this is a really funny story. But with me not being used to Florida humidity, me and Beck have a new book coming out soon, and I flew out to Florida to do a photo shoot with her.

Dr. Becky Campbell: (51:50)

Which was two months ago, by the way. For me, I was like, “Whew, it’s kind of chilly out!”

Dr. Krystal Hohn: (51:56)

You guys, I was not used to the humidity, Okay? We had the photo shoot outside, and I am not kidding when I say that I felt during the photo shoot like a wet poodle. I kept saying to Becky: “Girl, I flew out here. There’s no way these pictures are going to be beautiful. No way. No way. I look like a wet poodle. I’m sweating from my pits; under my boobs are sweaty.” Like, “I am just a mess,” right? And Becky is dying laughing. She’s used to it, but it was so humid! I don’t know how you guys handle that humidity. I mean, I remember Georgia, right?

Dr. Becky Campbell: (52:34)

Yes.  Georgia is hot but not humid, like Florida. And her hair was sticking to her face, and it was morning. I mean, I was just looking at her, and I’m like, “What is happening?” And Krystal is the most upbeat, chipper, and genuinely happy person you’ll meet. She was distraught. I mean, she was…

Dr. Krystal Hohn: (52:56)

I’m like, “I’m going to ruin our photos. This is crazy. I cannot stop my sweating.” But they turned out beautiful, didn’t they?

Dr. Becky Campbell: (53:05)

They did. And we did cut the photo shoot maybe a little short because we were starting to melt.

Dr. Krystal Hohn: (53:11)

So yes, we’re both excited. Your kids got out last week, right?

Dr. Becky Campbell: (53:16)

They did. They got out last week. It’s hard because we are blessed—so blessed—to work from home, right? We’re not complaining. But in all honesty, you still have the mom guilt even being home—even having to go in the room for a few hours while they’re just doing whatever. You want to be entertaining them. And I have three boys. So you want to be entertaining them, but at the same time, I can’t just shut the practice down for three months.

Dr. Krystal Hohn: (53:52)

No. I know. I had to kick mine out there, playing with the dog. I’m looking at them right out the window right now, just to do this podcast. But it’s worth it. It’s worth it.

Dr. Becky Campbell: (54:03)

It is. It is.

Dr. Krystal Hohn: (54:04)

It’s great. But yes, I’m excited for summer. It’s going to be good. [We have] so many good things coming up, Beck, too, for the podcast, don’t we? We have a lot of things planned for it. We’re so excited for the new book. There are just so many good things happening. I feel very blessed.

Dr. Becky Campbell: (54:19)

Yes. We’re making a little bit of a change with the podcast. We’ve had a lot of feedback that people want to hear from us, and that makes sense. So we’re going to be doing a lot more talking ourselves, and we are still going to have guests, just not all the time. We love feedback, too. So any feedback you guys have, you can definitely tell us, as long as it’s nice.

Dr. Krystal Hohn: (54:42)

If it’s mean, no.

Dr. Becky Campbell: (54:44)

If it’s mean, DM us. [laughing]

Dr. Krystal Hohn: (54:49)

[laughing] Oh, that’s funny!

Dr. Becky Campbell: (54:51)

All right, well, let’s get to some Instagram questions. Yes. I love to put up the question box, and we always get tons of questions. The first one we got was from Shannon.

Dr. Krystal Hohn: (55:05)

Yes. “What are the best workouts for someone with low T3 [and] T4?” When it comes to working out, again, whenever your body is going through a big stressful event or if you’re dealing with some major hormonal dysregulation, you want to be careful with the amount of added stress that you’re putting on your body. So even though working out is a good stress, you want to be careful that you’re not pushing yourself too hard. This is the same type of concept as [saying that] you don’t want to be undereating because it puts way too much stress on the body. So when it comes to workouts, I think for someone who’s dealing with really low thyroid hormone or any big hormonal imbalance, I’ll just say that. You want to do more comforting workouts, so lots of walks, Pilates, yoga. You could definitely break a sweat. But don’t do a lot of HIIT training; it’s just so much stress on the body. And even add in some really good weight resistance. Again, don’t do a lot of heavy, heavy lifting. But weight resistance is excellent for your metabolism, your blood sugar, and your thyroid. So that is the best, I feel, when it comes to that. Do you agree, Beck?

Dr. Becky Campbell: (56:25)

Yes, and this is why we love the guys at Mind Pump. They have all these online programs for resistance training, and they have different programs depending on what your goals are. So I do really well with their anabolic program, which is basically resistance training, but where you’re resting in between sets and you’re not doing this high intensity where you’re running on the treadmill and then getting off and doing weighted jumping jacks and pushups, whatever it is, and you’re just kind of overdoing it and you’re really exhausting yourself further. I love that program. It’s called MAPS Anabolic, and that’s what I’ve responded best to. That’s what I feel best after. My body responds best to it. So [I’m] doing weight training with resting in between. Don’t you do well with that too?

Dr. Krystal Hohn: (57:20)

Very well. Weight training with resting in between. I even like walking on an incline. If you’re dealing with heavy winters and you can’t get outside, or if you don’t want to go to a gym, if you have a treadmill at home, that’s great too. So, yes, you just want to be careful.

Dr. Becky Campbell: (57:36)

And I think having a goal of how many steps you want to get in a day and not necessarily having to do cardio as opposed to knowing, “Okay, I need to get 10,000 steps in a day.” Either you’re going to go for a couple walks a day or you’re constantly moving, and you’re going to get it from that. So I think that’s the best.

Dr. Krystal Hohn: (57:57)

Yes, for sure.

Dr. Becky Campbell: (57:59)


Dr. Krystal Hohn: (58:00)

And you want to make sure you’re moving throughout the day. We can mention that, right? All the sitting that we’re doing… Take breaks, get up, move around, move your body. You don’t have to just think, “Okay, I have my set workout time.” Just make sure you’re active throughout the day, too. That makes a world of difference for your metabolism.

Dr. Becky Campbell: (58:20)

A hundred percent. Yes. Sitting is one of the worst things you can do for your spine and the body.

Dr. Krystal Hohn: (58:25)

Me and Beck have standing desks. It’s great.

Dr. Becky Campbell: (58:27)

But also, standing can be an issue if you’re just standing. So you kind of want to move while you’re doing that too. I just got a new… I don’t know what it’s called.

Dr. Krystal Hohn: (58:38)

It’s like a wobble.

Dr. Becky Campbell: (58:39)

You wobble on it, but it’s kind of curved, and it actually puts a lot of pressure on the medial inner side of my knee, so I’m going to have to get a different one. But yes, just try to move around while you’re standing. So that’s that question. So let’s move on to Melody. She asked if there was any connection with thyroid disease, histamine issues, and lupus. So let me break those two down. Okay, so lupus is an autoimmune disease. So this really holds true for any autoimmune disease: Once you have one autoimmune disease, you are two to three times more likely to get another autoimmune disease. So yes, having an autoimmune thyroid disease, which would be either Hashimoto’s or Graves’, does really tie into things like lupus.

Dr. Becky Campbell: (59:29)

So this is, again, where the gut comes into play. Having something called a leaky gut, which is where the barrier of your gut lining is compromised. So your food, as you’re supposed to be digesting it, is getting out into large particles and causing a really big inflammatory response, which is not supposed to happen. So then your body can start tagging things as foreign invaders, and that can increase your likelihood of getting an autoimmune disease. And if you already have one, it can definitely increase your likelihood of getting another. So again, looking at gut health is important for that. So anyone listening who doesn’t know what histamine issues are, it’s a whole other…

Dr. Krystal Hohn: (01:00:00)

We’ll do another episode on that.

Dr. Becky Campbell: (01:00:14)

Yes, we’re going to do a third episode on that. We have two already, and it’s what my last two books are, and what we see a lot in the practice is mast cell activation syndrome and histamine intolerance. So in my first histamine book, I actually did… We are both big graph people, so we love to just look at graphs, right? So I did one for hypothyroidism and hyperthyroidism tied to the mast cells and histamine release. With hypothyroidism, you’re going to see an increase in mast cell production. That means mast cells kind of hold these inflammatory chemicals, and histamine is one of them. So you’re going to get an increase in histamine release with that. And then, with hyperthyroidism, you get an actual increase in histamine receptors in the body, meaning the places—I do this because that’s kind of what they look like—that our chemical messengers like histamine sit, there are more of those. So this can actually make you more symptomatic throughout the whole body if you have too much histamine coming into the body.

Dr. Becky Campbell: (01:01:17)

So yes, thyroid disease and histamine intolerance can go hand in hand, and estrogen can play a very big role in these because estrogen dominance signals your body to release more histamine, and then histamine tells your body to release more estrogen, and then more estrogen can be a problem for the thyroid. So yes, they can definitely go hand in hand. We see it all the time. I have mast cell activation syndrome. With my mast cell activation syndrome, I have histamine intolerance and hypothyroidism, which are both under very, very good control. I haven’t had to take thyroid medication. I really only had to take it twice in my life, and that was when I first got diagnosed and right after one of my kids. But my lifestyle changes have [meant that] fortunately, I don’t have to do that anymore. And also with the histamine, I tend to do really well and can even eat plenty of high histamine foods at this point.

Dr. Becky Campbell: (01:02:10)

All right, we have one more question. YogaBliss300. Sorry, I didn’t get the actual name on this one, but that is the Instagram handle. This question was: “What are the optimal thyroid ranges?” One thing I want you guys to understand is that conventional medicine has very wide ranges for the thyroid. This is why thyroid disease is missed a lot. Don’t you think?

Dr. Krystal Hohn: (01:02:37)

Oh yes. I can’t tell you how many times patients come to us and tell us, “You know, doctors told me my levels were good.” And I’m like: “You know what? Just send me your labs. Just send us your labs. Let’s look.” And it’s just way out of range. So their ranges are just so large—so, so large—when it comes to…

Dr. Becky Campbell: (01:02:57)

Yes. It’s like, what?—4.5 until you even notice that there’s an issue with TSH, which we don’t see that way. And this is highly recognized. Some endocrinologists do recognize this—conventional medicine. Or just the lab ranges in general—let’s say you go to Labcorp or Quest—are going to be too wide. So we’ve tightened those up, and that guide that we told you about really goes into a lot more detail. I’m just going to give you the high points. TSH—thyroid stimulating hormone—I like to see that between one and two. A little bit below one is fine; maybe a little bit above two is fine. Once we start seeing it at around three, we start to wonder, “What’s going on?”

Dr. Becky Campbell: (01:03:41)

And then free T4—you’re really more interested in the free versions of these—I like to see it between one and two. That’s pretty good to me. And then free T3, which is the most usable form of thyroid hormone, is between three and four. Anything when you’re getting towards four and over, you’ve got to be careful. You’re probably going to start getting some palpitations and that type of thing. But most people are under that. They’re not usually above it. So that’s when you start getting tired and [having] all those lovely symptoms of hypothyroid. And then reverse T3—I don’t like to see it over twelve. Fifteen is probably the max that I like to see it at, but really, I like to see it at twelve or lower.

Dr. Becky Campbell: (01:04:24)

We’re going to do more on the thyroid. We’re breaking it down into little chunks because it’s a lot to absorb. But we wanted to get some main points out to you guys. So this is a really good starting point. If you think that you have thyroid disease, you know what symptoms to look for and some resources. Obviously, we take patients virtually. We would love to work with you. At a very minimum, at least get the book, do the dietary changes in there, and just learn about it. And then we’re going to do some more. So we’ll ask for more questions. We’ll ask for more questions, and we’ll make some more episodes on this. Again, we thank you guys for listening and being a part of this.

Dr. Krystal Hohn: (01:05:10)

Great. You guys are going to love this episode, I feel.

Dr. Becky Campbell: (01:05:13)

We did. So give us your feedback. If you can take a minute to leave a review, that’s super helpful for the listeners to know what episodes you liked so that they can kind of know where to go with that. So thank you, guys, so much for listening, and we hope you have an amazing day!

Dr. Krystal Hohn: (01:05:33)