The Problem With “Normal” Thyroid Labs

Philip Pape 0:01

If you're someone who's been doing all the things with your nutrition and training, and your goal has been to lose fat, build strength, and finally feel like your metabolism is working for you, but your labs come back normal, and your doctor tells you everything's fine, even though you feel exhausted, can't lose weight, and something just feels off, this episode is for you. My guest, Dr. Amy Horneman, is going to reveal the forgotten thyroid hormone. One that most doctors never test, but that directly impacts your ability to burn stored body fat, boost your energy, and increase your metabolic rate. You'll learn what this hormone is and what it does at the mitochondrial level, and how optimizing thyroid function can help you burn fat more efficiently, recover faster, and have the energy to live and enjoy life to the fullest. Welcome to Wits and Weights, the show that helps you build a strong, healthy physique using evidence, engineering, and efficiency. I'm your host, Philip Pape, and today we're going to discuss why so many people, especially those over 40, are told their thyroid labs look perfectly normal, yet they struggle with stubborn fat, low energy, and a metabolism that seems completely stuck.

Meet Dr. Amy And The Case For T2

Philip Pape 1:16

My guest today is Dr. Amy Hornman, known as the thyroid fixer. She's a thyroid and hormone optimization specialist who's built her practice around helping the people who fall through the cracks of conventional medicine, the ones who get dismissed despite very real symptoms. Today we're going to focus on T2. T2 is an often overlooked thyroid hormone that plays a direct role in mitochondrial function, fat oxidation, and metabolic rate. You'll learn what T2 is and why it matters for fat loss, why standard thyroid panels are usually inadequate, how thyroid dysfunction shows up differently than you might expect, and what steps to take if you suspect your thyroid is holding you back. Because, dear listener, Amy and I are all about helping you understand what's happening with your body so you finally have the strong, lean, high-energy lifestyle you've been working so hard for. Amy, it's a true pleasure. It's an honor to have you on the Wits and Weights podcast. Welcome to the show.

Dr. Amie Hornaman 2:11

Oh, well, thank you so much. It's an honor to be here.

Philip Pape 2:13

Now you've covered T2 on your show quite a few times lately, including on a recent episode, it was called How to Lose Nine Pounds in 28 Days. Right. Right. Great title, right? It brings you in. Like, what is she talking about? And it clearly positions this hormone as a fat loss and energy performance enhancer. It's also available

Why T2 Stayed In The Shadows

Philip Pape 2:32

over the counter. So the obvious question is if T2 is so incredible, why the heck haven't haven't we been talking about this all along?

Dr. Amie Hornaman 2:39

I know. Seriously, Philip. So, okay, let's let's start with a little bit of history and then we'll take it into the present, what we're kind of dealing with right now in present-day fat loss uh efforts. So if we go back 30 years, well, now it's it's around like 35 years. There's been 35 years of research done on T2, but it just hasn't been released out into the general public. It's not common knowledge that this molecule, this hormone, is so powerful when it comes to increasing our baseline metabolic rate. So literally the amount of fat that you're burning just sitting here, just listening to the podcast, just sitting on your couch watching Netflix. That's our resting metabolic rate. So that's without exercise, without movement. T2 has been shown over and over and over again in multiple studies to increase fat burning, increase our metabolism, decrease inflammation, turn on a gene that literally prevents fat from accumulating on our body. It reduces oxidative stress, it improves our lipids, it improves our cholesterol, and it only targets body fat and not muscle. Now, why I say that is because that brings us into the present day of this obesity epidemic. We now have GLPs. They have taken the stage, they have taken the forefront. And everybody and their brothers on a GLP right now. I used to call them the Beverly Hills Soccer Mom Drug of Choice for weight loss, because if you had 10 pounds to lose, you pop on a GLP, you lose the 10 pounds, and then you know you're good. But the issue is that we're seeing with GLPs over and over again is that they are burning lean muscle. You know, Peter Atia told us that four years ago. Hey, 40% of the weight loss that we're seeing with these GLPs is lean muscle tissue, that precious muscle that we need to keep on our bodies. It's our organ of longevity. And we're also losing fat. We're getting Manjaro phase. People are looking 10 years older than they are. And the other issue is it's just killing our appetite, and we're not actually changing the way that we're eating. So, in my opinion, now this could be a whole other podcast rabbit hole, but why haven't we heard about T2? Because it's not a drug, it's not a pharmaceutical. Eli Lilly doesn't own it, Pfizer doesn't own it, just like they do the GLP. So we're not hearing about it in mainstream as a true potential answer for the obesity crisis that we're in, because it does so much, because it would wipe out statins, because it helps with insulin resistance, because

T4, T3, And Conversion Roadblocks

Dr. Amie Hornaman 5:21

it actually decreases inflammation and helps fatty liver disease. Well, there's five drugs right there that can't be prescribed anymore. They start healing you. And then there's the big elephant in the room drug of choice, the GLPs. So I think really that's why it's not getting the spotlight that it deserves.

Philip Pape 5:41

Yeah, that's a viable answer that that I've thought about myself, because you look at, for example, just simple herbal supplements we've known for thousands of years, like Ashwagandha. Ashwagandha is massively helpful to people with anxiety and stress. And, you know, you get it over the counter and it's actually put into some multivitamins today and things like that, but it's not patentable, right? It's not patentable like these drugs. Um, same thing, like you said, hormone replacement therapy, peptides come to mind there. And I know peptides are just at the verge of where we are with that. So, in that case, I guess let's look at the science first. Like, what makes it functionally different from T3 and T4? And then I would like to understand, you know, access and dosing, and like what should people think about if they even want to consider T2?

Dr. Amie Hornaman 6:23

All that fun stuff, yes. Okay. So, first of all, when we look at all the thyroid hormones, your thyroid gland does produce T1, T2, T3, and T4. Now, T1 we can set aside, it's totally inactive, it doesn't really play a role, it doesn't convert. So we'll just push that over here. Then we'll look at T4 next, because that's the other inactive thyroid hormone. When our bodies produce T4, it has to go through a conversion process where one iodine atom is removed and it literally becomes T3. There's no receptor site anywhere in your body for T4. So that's important to remember because many of your listeners might be on something of a medication for their thyroid called syntroid or levothyroxin, levoxyl, tyrosin. That's only T4. So it's really important for everyone with a thyroid problem that is on this medication to recognize the fact that it is inactive. Your body has to take that T4 and convert it. Now, the problem with that is conventional medicine assumes that, well, the body just does that. It'll convert it, no problem. That's all we need to do is give you some T4 and you'll be fine. The reality is that that conversion process, I attribute it to running 10 tough mutters in a row. It's really hard for your body to do. If you have insulin resistance, vitamin D deficiency, selenium deficiency, uh iodine deficiency, magnesium deficiency, if you have excess cortisol, if you're under stress, if you're estrogen dominant, if your hormones aren't balanced, if you have a genetic snip, all of those things can interfere with that T4 to T3 conversion. So just, I mean, that that laundry list alone, you go, well, yeah, that kind of does sound like a hard job for the body to do. So T4 has to convert. Doesn't easily do that. So let's move on to T3. T3 is the active thyroid hormone. And yes, there are medications that are T3 based. That's liothyrinine, cytomel, and there is 20% T3 in the thyroid medication called natural desiccated thyroid. It kind of comes under that umbrella. That would be your armor or your NP thyroid. Those medications are 80% T4 and 20% T3. So we get a little bit of a sprinkle in there. But it does have to be prescribed. Now, do we have receptor sites on our cells for T3? Yes. Yes, everywhere in our body, we have a receptor site on every single cell. So I always say from head to toe, the thyroid runs the show because literally the growth of your hair down to whether or not you poop every day is dependent on your thyroid functioning and you having enough of that active thyroid hormone T3. Now, T3 is great in that, yeah, it will absolutely increase our metabolism. However, it does not differentiate between muscle and fat. It will burn both because it just is increasing the overall fire. It's increasing your energy expenditure. It's not sitting back saying, okay, that precious lean muscle over there, I mean, very similar to a GLP. That precious lean muscle over there, we're just gonna leave that alone. No, no. It's going to burn fat and it's going to burn your muscle at the same time. Now, if it's properly dosed, if you're managed by someone who knows what they're doing with the thyroid, you're not going to be over-medicated on T3 and you will have just enough to optimize your thyroid, optimize your body where it's not burning muscle, but you do have a decent metabolism. The problem is not many people know how to dose T3 properly. Even functional practitioners, I have seen them give these little baby doses of T3 that do nothing for a person, or they're not paying attention to whether or not that person is converting their T4 to T3. So we do run into some issues there. And a quick story, because this will lead us into T2.

Muscle Loss, GLPs, And Metabolism

Dr. Amie Hornaman 10:25

When we're looking at the power of T3, we always have to go back to bodybuilders because bodybuilders were the OGs of biohacking long before Asprey came along. Love you, Ben Greenfield. I know you were a bodybuilder too. But again, let's go back to like Jay Cutler and you know that literally like 30 years ago and look at what they were doing. Okay, well, when I was competing, yes, um, people were using and abusing T3 to get ready for a show because it burned body fat. The problem was, and I and I saw uh one of the trainers to the pros being interviewed, and I loved what he said. He said, here's the problem I don't give my athletes T3 to get ready for a show because it's going to burn their muscle that they've worked so hard to build and maintain. And number two, they're gonna come out the other side of a show with a thyroid problem because there is that negative feedback loop. Anytime we take a medication hormone, there's going to be a message sent to our brain, our hypothalamus and pituitary that does all the talking to the rest of our body. And it's going to tell our brains to just quiet down the production of that hormone. So, in the case of thyroid, it's telling our hypothalamus and our pituitary to like, you know what, you can just tell the thyroid gland that it can step aside and go take a nap. It doesn't need to produce its own hormone anymore because there's enough going on in the body. Well, then that's why you see competitors gain 40 pounds in two weeks after a show because their thyroid has totally crapped the bed and now they legit have a thyroid problem. So this trainer goes, you know, I only use T2 because it leaves the muscle alone, it only burns body fat, and it does not have a negative feedback loop on the thyroid because it's only working at the mitochondria level. And he is right. When I dove into the research, now I've been studying T2 for about 15 years, and looking at all the research, it does not have a thyrometic effect, meaning it's not going to come back and suppress your TSH. It's not going to tell your thyroid, hey, you don't have to work anymore. It's not going to change your numbers to where your doctor's going to go, oh my gosh, Philip, what have you been doing? You're hyper thyroid now. No, it does none of that. It literally works at that mitochondrial level to produce ATP and to increase thermogenesis or increase the amount of fat being burned. And then we're seeing other benefits as well.

Philip Pape 13:10

Oh, okay. I want to get into that. Before we do, I just want to clarify something related to T3. And I guess it affects GLP1s as well, because you mentioned muscle loss. And of course, our listeners understand the value of strength training, and there's going to be differences between populations who lift and don't. If you don't, you're absolutely going to lose a ton of muscle. If you do, though, let's say if you do, and you're talking about bodybuilders, obviously they do, is it that the T3 ramps up the energy expenditure such that you're in a much more aggressive deficit and that's why you're losing muscle, or is there an above and beyond impact going on?

Dr. Amie Hornaman 13:41

So yeah, I believe with the GLPs, there's something else. Because even anecdotally, when I've been playing with even microdosing GLPs, or when we're, and I am not anti-GLP, by the way. I do believe that if you use a tiny dose in some populations doing that microdose, we see a decrease in inflammation. And obviously, if someone is full-blown type 2 diabetic, I mean, I've had patients with A1Cs of uh 13. Yeah, let's get some GLPs on board because that excess weight and that inflammation that goes along with having type 2 diabetes is way more detrimental than losing a little bit of muscle. You know, you have to weigh your pros and cons here. But I think, you know, what we're seeing with the GLPs, there's something we don't know. And we're still seeing muscle loss despite adequate protein intake and despite lifting heavy. So with T3, we don't see that as drastically. I mean, that really is it is

How T2 Works At The Mitochondria

Dr. Amie Hornaman 14:42

more manageable when you are lifting, when you're eating adequate amounts of protein, when you're feeding your muscle appropriately, getting in amino acids. We don't see as much muscle loss with T3 when used appropriately. But when we're talking about like kind of looking at the performance enhancer area. You know, you're you're talking about higher doses in a shorter amount of time, specifically designed to rev the metabolism to burn as much body fat as possible in those eight to 12 weeks of contest prep. You know, you're probably going to be looking at a little bit of muscle loss there too, despite the lifting and the eating, because those people, that subset of the population is already in a caloric deficit in preparation for the show, possibly a little bit of a nutrient deficit. I know I've been there. And then you're going to have a little bit of muscle loss when you're using T3 in that population.

Philip Pape 15:35

Yeah, it's always interesting to break apart the energy expenditure side from the physiologic, like what are these other effects going on? So then that leads us to T2, because you said, okay, it works at the mitochondrial level. It doesn't have the same phenomenon of muscle loss, and then it doesn't negatively affect your own thyroids production. So all of that sounds great, especially if I think you've talked about how it's over the counter and doesn't need to be prescribed or even used if you have thyroid disease. It could just be something we use as an enhancer. So let's get into T2. Like, what does it mean? How does it work? Um, what's going on? Like, lay it on us.

Dr. Amie Hornaman 16:11

Yeah, absolutely. Well, so how I was exposed to T2, like I said, about 15, well, maybe 20 years ago now. Yeah. 20 years ago, I started looking into it because it was available over the counter in supplemental form, but only kind of in that bro science population. So there was a company that had had a really angry name and literally, I kid you not, had like a gorilla with claw marks on the front of the bottle. So here I am meeting with 45-year-old women, needing to lose weight. And I'm like, um, yeah, you're just gonna have to trust me here. You're gonna want to go to this really angry, chaotic, painful website and order something with a gorilla claw on it. And they'd be looking at me like I had five heads, like, really, I'm gonna take this. Is this safe? I'm like, trust me. So anecdotally, I was using it on myself, on my patients, and seeing tremendous results. And this was even in the subset of patients who didn't have an open-minded doctor. So at the time, I didn't have my team where we could prescribe to all 50 states. So I was working with people trying to advocate for them to their doctor, hey, this person's on T4 only. It's not working, they've gained 30 pounds, they can't lose it. Can we please like change up their thyroid medication, add in T3? So obviously we hit a lot of roadblocks there. And a lot of the patients were on T4 only, and it just wasn't working. So that's where I would say, you know, hey, Susie, just trust me, add this in. And then we were seeing weight loss, we were seeing changes in their body, we were seeing inflammation go down. And that's what really piqued my interest, and that's where I dove deeper into T2. So then we started looking at the studies on it and seeing, oh, look, in 28 days, we're seeing a drop of 4% body fat, which is huge. We're seeing a drop of an average of nine pounds. Some lost less, some lost more, an average of nine pounds in a month when using T2. And it became really interesting to me to look at all of the other benefits

Real-World Results And Emerging Research

Dr. Amie Hornaman 18:18

as well, like the improved fatty liver, improved cholesterol panels. We're seeing a decrease in insulin, improvement in insulin sensitivity. And then most recently, the study that came out within the last year or so is that it's actually turning off a gene that allows fat accumulation. So that's huge. I mean, if you're someone that you're like, I look sideways at a brownie and I put on five pounds, this can help because it's literally going to improve your metabolism and it's going to, if you are one of those easy gainers, it's going to stop that fat from easily accumulating on your body. Now that does it's not a license to go eat what you want. But if you are one of those people where you're like, I can't enjoy anything. Like, I can't even go out to eat with my husband and have an appetizer or a glass of wine because I'm going to pay the price and be five pounds heavier tomorrow. That's huge to be able to have that social life, have that enjoyment again without being worried about the scale going up all the time. So that's how I was introduced to T2 and how I started studying it. And then fast forward to four years ago, when I was starting the fixer line of supplements, I knew that that was going to be the forefront. That was the first product to come to market, the first thing on the shelf is going to be T2 because of all the years of studying that I did and how beneficial it was. I knew it needed to come to market, not in an angry broscience form with a gorilla on the front. So we are today.

Philip Pape 19:59

I'm not even uh you know attracted by those things anymore, like my 25-year-old self might have been. That's kind of funny. So two things I want to ask about then. You mentioned some of the biomarkers, uh like lipids improving. You mentioned insulin sensitivity and then this gene for fat storage. So what I'd like to separate out is on one hand, um, what is being improved simply by virtue of this higher energy flux or the weight loss? And what is being improved with true like nutrient partitioning and things like that. Because when you mentioned the gene for fat storage, my brain always goes to the numbers, like the math and like, okay, so if you had that extra brownie, are you now burning a few more calories and therefore it's just netting out or are you like shuttling that into a little more repair and building of muscle tissue instead of storing of fat. You know what I mean? That that's where my brain goes.

Dr. Amie Hornaman 20:50

Oh yeah. I like how your brain works actually. So I'll work backwards. The the gene study is so new I haven't seen anything other than that one that came out. So I'm still waiting for more research to be done. And that is an area that I just don't know if we're going to see it or not because it's not a pharmaceutical. And I I think we've seen that a ton if you look on PubMed NIH, it's really hard to find studies on nutraceuticals, on herbals, on things like ashwagandha because you can't patent it and you can't turn it into a medication. I mean that's just the reality of it.

Philip Pape 21:30

So real quick on that, I totally know what you mean. And then you get the criticism that the few studies you do find are funded by the supplement companies as if that's the be all end all of why they're poor studies. And some of these are very good studies. And I I hate that for them because sometimes there is really good research but it's only paid for by one company because that's in their interest, right? So anyway, yeah.

Dr. Amie Hornaman 21:54

No, that's true though, because on that note I have thought about like ooh I wonder if we could run you know a double one placebo control a study. But but the money that it takes to run that I mean you would basically have to be Pfizer in order to have that kind of cash to run that kind of study. So there's a barrier

Thermogenesis, Brown Fat, And Uncoupling

Dr. Amie Hornaman 22:14

right there is when you are a an individual owner of a supplement company, I mean number one, those are the companies that you can really trust. I've been saying that since my days of competing I I was I I remember telling my nutrition clients like hey when you buy protein powder buy it from Gaspari or Labrata because those dudes still own the company like small businesses and but the issue is that we don't have that kind of money to run those kinds of studies. So when you do an kind of like an of let's say 10 study it gets a little bit more criticism because oh well it wasn't controlled all of that but I got to tell you we we actually did it was called the fixer transformation we took 15 ladies 11 of them made it through and they were all taking T2. They were taking thyroid fixer metabolism fixer from my lime and I actually met with them but not as patients. I met with them beforehand I looked at their labs and like some of these women have thyroid problems. Some of them have low hormones and need hormones some of them are on T4 only and I remember thinking I don't know if this is going to work for them. Is it going to break through that metabolic barrier that having low thyroid function that being on T4 only that having low hormones puts you in and it did. I mean that was the big thing was like okay and that woman on T4 only she lost 11 pounds in four months and this one lost 35 pounds in four months. I mean it was incredible but it's not publishable because it wasn't double blind placebo controlled. So I think that's that's definitely one of the barriers.

Philip Pape 23:51

Well you addressed the gene one and then the other one was about the weight loss if that's really the cause behind improved lipids and biomarkers or if there's again other benefits kind of like we're seeing with the what's the latest GLP one starts with an R that they're looking at yeah and they're looking at like fatty liver how it directly impacts liver fat potentially. So anyway is that the case here or is it multiple variables going on or what?

Dr. Amie Hornaman 24:14

So multiple variables um number one we do see just a general increase in thermogenesis. So they you know obviously before the human studies they did multiple studies on rats and what they found was when the rats were when they were even given high fat diets which would be the equivalent to us as humans eating around 2000 grams of fat, which is unfathomable. But if we did I think we could all agree we're probably gonna gain weight like I don't care if you're keto or carnivore, if you eat 2000 grams of fat, you're going to put on fat. Like that's just the bottom line. So these rats were put on a high fat diet, given T2, and they still increase thermogenesis or the burning of stored body fat and still lost weight. We also are seeing a browning of white adipose tissue. So that's why we jump into cold plunges right we want to ultimately brown the white squishy fat that we grab and we say I don't want this anymore and we want to turn it brown and that becomes brown fat is more metabolically active brown fat improves our insulin sensitivity. So there's that mechanism going on as well and then the third is that there is mitochondrial uncoupling. So we would see that again going way back to the OGs of biohacking the bodybuilders do you remember clen butyroll? Do you remember when when the bodybuilders were using Clen to also burn body fat there's mitochondrial uncoupling there. And basically what that means is that your body is is increasing the fat burning while leaving the muscle alone so they term it in these papers they term it as an exercise mimetic because when we look at exercise we're building muscle we're burning body fat we're improving our lipids we're improving our insulin obviously we're we're moving fat out of our liver to a to a point uh during exercise and T2 does all of those same things so while it's not a a a green light to not exercise and just sit on the couch and take T2 it does produce the same benefits of exercise. So it's kind of working on a on a multitude of different layers and then again at the mitochondria level we're seeing ATP production so it's also producing steady

Appetite, Energy, And Safe Use

Dr. Amie Hornaman 26:45

energy. And that's what I've also seen in my in my hypothyroid people using it when you have a thyroid problem sometimes you have it's this indescribable low energy. It's like this you can't get going and you don't even know why you're like oh why am I so tired? It's noon it's two it's three it's four I'm still dragging and literally you just drag through the day. Well instead of taking a stimulant because there's nothing stimulating about T2 it's not like a you know the fat burners of old where you felt like you were having a heart attack it just increases ATP so you have that like steady energy through the day. Yeah life is so much better now. So yeah it it's working on a a multitude of different levels. Now to answer your question about the the shuttling of nutrients that I haven't seen. I don't know I can't answer that if it shuttles things differently I'm not sure.

Philip Pape 27:45

I mean one thing that does come to mind though if you have just increased thermogenesis in general and you could eat more, that leads to a host of positive effects in that you could have more carbs for recovery, you could have more nutrients, you know, all those things people underestimate like you know Brandon de Cruz and others are big into energy flux discussion of like eat more and move more. So obviously if thyroid's working against you you can't eat more because you're going to gain a bunch of weight. So once you resolve that now you could eat more move more. I was looking up um trying to find one of these studies you were mentioning. I think I think I found one it was on rats. I'm sure a lot of these on rats because like you said we we don't have the a lot of human trials yet that was talking about mitochondrial integrity including fusion fission and mitophagy. And it it basically it talks about the exchange of contents routine damage and healthy mitochondria and counteracting the effects of hypothyroidism as well. So it is kind of interesting this is comparative effects of I'm not even going to pronounce it the whole compound for T25 diado al thyroid knows 35 diado with two eyes the L thironing yes and 353 triado L thyroid which that's is that T3 okay on mitochondrial damage and sea gas sting driven inflammation in liver of hyperthyroid rats. That's probably one of the ones on the list that you've maybe looked at anyway just trying to nerd out on this stuff. Okay so then is this something somebody should just go try it out or and and I ask this seriously because do you measure for T2 in the blood or do you just or not?

Dr. Amie Hornaman 29:13

Well we can't because they they do have a T2 assay for the studies that we saw in humans but there it's not available at Quest and Lab Core. It's not like we can order it for you. However, based on all of the research and the safety profile of it if you have to lose weight now where I wouldn't use T2 if you are an ideal weight if you are underweight if you are hyper thyroid if you have an eating disorder like no but outside of that little list it's safe for everyone to use I mean you're decreasing inflammation you're reducing oxidative stress right there bonus bonus. And obviously if you're improving your metabolism that's another bonus if you're losing

Where T2 Fits In Your Routine

Dr. Amie Hornaman 30:03

excess body fat, improving lipids, improving your insulin sensitivity, bonus, bonus. And it's like longevity bonus. It's not just aesthetic of course we don't want excess fat on our bodies we want to have that body composition that we're we're confident and we're comfortable and we love getting dressed and we feel good. But then there's the longevity aspect too like I said earlier the the detriments the health detriments of carrying excess body fat far outweighs a little bit of loss of muscle. So like in the case of my one patient with an A1C about 11, yes, we're going to use a GLP1 on her because we want to reverse her diabetes and she needed to lose about 150 pounds. So in that case okay let's bring in the big guns but if we can just improve someone's A1C, improve their insulin, improve their lipids that might just be a little bit off not dramatically, but just a little bit off well then that's huge for longevity. We know inflammation affects or all cause mortality you know from Alzheimer's to cardiovascular disease to cancer to anything that's going to kill us basically or make our life shorter stems from inflammation and stems from excess body fat, high insulin. I mean really the fastest way to age keep your insulin high, right? So if we can improve all of that beneath the surface, then you get the aesthetic benefits and the longevity benefits at the same time.

Philip Pape 31:33

Got it. So moderate weight loss, not an eating disorder, not hypothyroid, potentially other issues that might interfere and I'm a big advocate of like the whole body approach you need to figure out your immediate constraint and kind of attack them one at a time. For many of you it's just you're not active and not lifting weights start there. For many of you you're doing all the things and still struggling so I think this is helpful. It then brings up more questions. This episode drops in the middle of a whole series on appetite that I'm doing and I wonder this is kind of attacking from the other side right like GLP1's attack from the appetite I feel like this attacks from the expenditure side but does it affect appetite?

Dr. Amie Hornaman 32:10

No T2 doesn't now in my metabolism fixer I added suppresa which is a saffron extract that's been shown in studies to reduce cravings reduce appetite reduced cravings by about 67 to 69%. But we're not seeing the complete crushing of an appetite like we are with the GLPs where literally I mean I am speaking from experience I experimented on myself. So I'm not just going by what people told me I felt it and it is wild where you are looking at this beautiful ribeye and you literally take a bite and you go, I just can't anymore. I I can't even take another bite like you just can't no suppressa is not going to do that. It's going to take the edge off so that you don't overeat so that you're not snacking so that you eat the ribeye but you don't need the chocolate chip cookie afterwards. Yeah. But T2 alone like that what what is in thyroid fixer I don't have suppressor in there, there's no appetite suppression at all.

Philip Pape 33:12

Yeah and and for many they may not need it right for many, I mean I've worked with women who when I first started coaching it was very frustrating when a woman in her 40s or 50s just plateaued very quickly during a fat loss phase doing all the right things and it was like what the heck's happening and we would track their, we would calculate their expenditure right I know a lot of people don't still don't do that today, which baffles me. It's like you've got to figure out roughly how many calories you burn beyond just using a calculator and it was a thyroid, it was usually a thyroid issue. And it wasn't that they were eating too much. It's just that they couldn't burn as much as they needed to eat a reasonable amount which I think is this solves. So then that raises the question what if you're not dieting what

Cardio, Strength, And Thyroid Health

Philip Pape 33:52

if you are at a reasonable weight for yourself, you know, decent body composition is this a good thing to do when you're at maintenance does it still provide those other benefits that are worth taking T2 long term and I guess that's a side question is do you take it long term or is it like a short term thing?

Dr. Amie Hornaman 34:07

I mean you can really kind of personalize it. So how I take it because I am I'm I'm at a decent weight I'm good staying right here don't want to lose anymore. What I do is I'll add it in let's say coming up next week during the holidays where I know I'm eating the cookies Philip I'm I'm eating the damn Christmas cookies. So I'm not gonna deprive myself but I'm gonna have a little bit of fun but I know that you know weight gain can happen during that time. So in order to keep my metabolism up a little bit more I'll take it during that time or if I'm going on vacation or you know just adding it in bringing it in and out for that purpose. But I would say yeah if you are at a decent weight and you're like I'm good then you don't need it. Now if you have low energy if you're at a decent weight but you're like oh I got that energy drag through the day that she's talking about then yes that is a a beautiful way to maintain nice steady energy. And then at the same time I would say to everybody still have your thyroid check. Look at your hormone function because just like anything T2 is going to work better in a primed body. So you know we hear that a lot with peptides any peptide especially the GLPs they will not work if let's say you're you're so hypothyroid and you're not even being paid attention to or tested or treated or your hormones are in the toilet you're not on bioidentical hormone replacement you have no testosterone whatsoever your estrogens in the in the basement um it's either not going to work or it's going to take a really long time or if you're eating like garbage and you're not moving like that's hard to overcome. Now in the in the fixer transformation ladies we saw T2 overcome some of those blocks but in general I would say to the listener like please don't think that you're going to put T2 on a dumpster fire and have it work.

Philip Pape 36:05

It's just not yeah that that's important in the pyramid right like supplements are are the icing on the cake they can be super powerful and they're accelerated when you're doing the other things right you'll I'm sure you've gotten reviews like oh this thing doesn't work at all and and it's somebody who just their lifestyles it's either that or they'll use it for like three weeks and it's like man this is not a GLP drug.

Dr. Amie Hornaman 36:27

Yeah it's not going to work in three to four in fact you can and for those people I go when you take vitamin D, do you think your vitamin D is going to go from a 20 to an 80 in three weeks or you think it's going to take a couple of months when we give hormone replacement therapy we are prescribing hormones I still tell my patients now hormones take about three months to build up and to get to those optimal levels where we know what your dose is going to be where you can coast. If hormones take three months do you think a supplement

Listener Q&A: Antibodies And Remission

Dr. Amie Hornaman 37:00

is going to work in three to four weeks so it's yeah it's it's about expectation too as as well as not putting it on a body that is wrecked.

Philip Pape 37:09

Something we struggle with all the time in this industry is like balancing realistic time patience expectations for if you want something that sticks long term, you're gonna have to be a little patient but listeners, come on, you've been struggling with for 20, 30 years what's another six months to do it right like that's what I always say what's six months to do it the right way what about side effects?

Dr. Amie Hornaman 37:28

We haven't seen any yet the only reports that we've gotten from some customers is that they certain really sensitive people can feel a little bit of that amp. You know so when you push ATP some people be like whoa I felt a little bit jacked up like did I drink a Red Bull like my heart started palpating a little bit. Now sometimes it's the matter of if you are in that hypothyroid state like you truly do have a thyroid problem or you're on T4 only a lot of times and I hear this from patients as well when we start treating them, they'll say oh my gosh my heart rate is high. I go what is it? They go it's like 65. I'm like okay so that means that you were really low before like you actually got used to a 50 beats per minute heart rate not that you were Lance Armstrong, but that you were just hypo low and slow. And now we're bringing you into a normal range and you feel like it's high and you feel like it just got jacked up. Now that's totally different than somebody that's like oh I'm sitting here at my desk and my heart rate's 130. Okay, but like let's let's back off something if that's happening. But a lot of times people will just feel that little bit of ATP production and feel amped but they're really kind of coming into normal.

Philip Pape 38:43

Interesting. So in in the totality of someone's like regimen or protocol, right? Like somebody who is not who doesn't have any hormone issues, where does this all fit? And what I mean by that is you know we usually talk about the pillars like you've got lifting and maybe your steps and your sleep and you know where where does all this fit and then how would it what other supplements do you are you big on along with T2?

Dr. Amie Hornaman 39:07

Yeah absolutely so I think it fits into just like you said a couple minutes ago that that that pillar of supplementation support targeted therapy for what your body needs. So you okay you need to lose weight you need better energy okay here it is that's that target in addition to the lifestyle and the sleep and the nutrition and the movement you have to have all of that. And then the the baseline supplementation support so I call that the no duh list meaning of course duh of course you're gonna take these every day. So my no duh supplement list is vitamin D, magnesium, selenium in a small amount in the form of selenomothionine I like using a hundred micrograms, not 200, not 400. Side note the problem with some thyroid patients is they get so desperate And they do want results yesterday that they read a blog that selenium helps your thyroid, and then they start popping it like candy.

Philip Pape 40:07

And I'm not eating a lot of Brazil nuts, right?

Dr. Amie Hornaman 40:09

Oh, like a bag of Brazil nuts every day, or they'll take like a 400 microgram or 200 microgram uh selenium supplement. I'm like, that's too much. That can actually increase your reverse T3. So you want kind of the Goldilocks sweet, sweet spot. And I love iodine. And I know that's a whole other controversial topic, but for me, that is part of my no dah supplement list as a baseline supplement in the proper amount because our thyroid needs it to produce T4, T3, and T2. Our thyroid gland needs it to convert that inactive T4 to T3. And it's antiviral, antifungal, antibacterial, and it helps detoxify our bodies from chlorine, bromide, and fluoride, which are very toxic halogens to your thyroid as well. So I like iodine as a baseline too.

Philip Pape 40:58

So selenium and iodine, right? I mean, the argument always is why not get those from food? I know magnesium, it's almost impossible to get enough from food, let's be honest, in the food supply, but it does the same apply to selenium and iodine?

Dr. Amie Hornaman 41:10

You know, I used to say, ah, you know, just eat a Brazil nut or two every day. But then kind of looking more into that, the

Listener Q&A: TSH, Bones, And Myths

Dr. Amie Hornaman 41:18

again, we kind of come back to what's wrong with our food supply, where was it grown? Was it exposed to pesticides? Was it exposed to heavy metals in the soil? Um, how much selenium is actually in each Brazil nut? There are different sizes. So it became too much of the Wild West just telling people to eat Brazil nuts. I mean, while it's beautiful to get nutrients from food whenever you can, unfortunately, in the time that we're living, that's getting harder and harder to do because of the soil depletion and just everything that we're using on our crops. So I just say, you know what, go ahead and supplement with it. It's just, it's steady, it's easy. You know, you're getting it in and call it a day.

Philip Pape 42:00

Yeah, I kind of agree. I mean, uh, same thing with multivitamins or um vitamin C or like uh what's another creatine, obviously, but creatine is its own thing. You can't get enough from food. I guess you could, but that'd be a lot of meat. A lot of meat. Yeah, that'd be a lot, a lot, a lot of meat. Yeah, like five times as much. So, okay, that's that's good to know. The the dud list sounds totally reasonable. Um, and then, you know, one thing I wanted to ask you, because we did talk about strength training a couple times, that I'm always curious about is how it affects your thyroid. Obviously, we know dieting affects your thyroid temporarily, you know, downregulates it, just like all your other hormones, but then it recovers. You know, strength training can be really stressful for some people who have done the wrong way or if like they overtrain. And I just wonder like, where's the line of how beneficial it is to your thyroid as a natural thing to do versus not?

Dr. Amie Hornaman 42:47

The big thing we see impact the thyroid are more so the cardio queens. It's and and I get it because when I was being misdiagnosed and my body literally laid down in excess of 25 pounds in a short amount of time. Yeah, I did cardio. I cardioed my ass off in hopes that maybe that would help me take off some of the fat that was coming on my body so rapidly. But unfortunately, that produces an excess of cortisol, which downregulates your thyroid. And we just know that strength training is so much better. Actually, I don't even do cardio anymore. My cardiovascular system gets a workout from lifting heavy because if you lift heavy enough, you will be out of breath. Or I'll do some, you know, HIIT training like the infinity rope or something like that that gets my heart rate up. But I no longer do a machine for cardio and I certainly don't run. I just focus on doing strength training. And there's nothing wrong with that. It's very, very rare that someone will overdo strength training. I mean, you and I talked a little bit about CrossFit before we jumped on. Okay, there's that subset of the population that maybe that's a little bit overdone. But I think even that has changed through the years, and we're not seeing the same like crazy intensity that we once saw, where people were really like going into rhabdo and really crushing their bodies. But I really believe that we need to get away from this hour-long cardio session, the Peloton, the even just the 45-minute, like long steady state cardio or running. You know, you just can't. You you just can't do it. And I my husband was a runner. Quick story, because this impacted him from the beginning when I told him this. He used to be a runner. Now he would lift weights too, but he would always run. And I would say, Han, let me just tell you something. Just get this picture in your head. First of all, I want you to picture what a a sprinter looks like, an Olympic sprinter. The the guys that maybe do a quick hurdle or a sprint, they are jacked. They could step on a bodybuilding stage the same day that they're in the Olympics and win. They have muscle

Final Takeaways And Where To Find Dr. Amy

Dr. Amie Hornaman 45:00

and they're tight and they're lean. And I said, now I want you to picture your typical marathon runner. And what do they look like? They're a skinny fat, they're they have no muscle, they're lanky, they're sick looking. In general, now, if you're a marathon runner out there and you're jacked up and you're awesome, that's fine. I'm talking in general, when you look at these marathon runners, they look bad. And he goes, Right. And he will still he will still reference that conversation to this day because that totally changed his workouts and he stopped pounding the pavement because he was really doing nothing except wearing out his joints.

Philip Pape 45:37

We are totally on the same page. I I recommend sprinting, like anabolic sprinting, very short, like one to six work to rest ratio. Learned it from Brad Kearns actually, not long ago. Um, that walking and lifting, like is pretty much all you need to be and and getting up throughout the day. I think that's super important too. There's um, Amy, there's some really cool studies about like getting up a couple times every hour and walking in terms of how much it swings your muscle protein synthesis and insulin sensitivity. So that combined with all this other stuff is really great. All right. I have two listener questions from someone. Her name is Carol. Um, she's also an assistant coach who knows a lot about thyroid from her personal experience. She has Hashimoto's. And so she wanted to challenge you a little bit with some more advanced questions that I'm hoping we can answer. You want to give it a shot?

Dr. Amie Hornaman 46:19

Yes, let's do it.

Philip Pape 46:20

Okay. The first one is I would love to know more about thyroid peroxidase antibodies and thyroglobulin antibodies. If someone's levels of those are very low, mine are one and two, for example, does this still mean they have Hashimoto's or have I successfully put it into remission?

Dr. Amie Hornaman 46:36

Amazing question. Okay. So first we have to think about those antibodies as soldiers that are going out and beating up your thyroid gland. Right. So if we if we if we just start there and we think about every number that you see next to your TPO and your TGA is a little soldier that is confused and thinks that your thyroid is a bad guy and likes to go out and regularly attack it. So if you have two soldiers, okay, I mean, it's not something to dismiss, it's something to pay attention to. But at that point of time, you could go, okay, well, maybe I can do things here naturally to support my body and push it into remission. Adding in things like black human seed oil is amazing. I mean, we we have seen, I have, I added it to my line, it's Hashimoto's fixer, but we have seen people go into full remission when they add in black human seed oil. Um, going gluten-free, controlling your stress, all of that. Very beneficial to even push those down to zero. Now, the other thing to keep in mind is that antibodies often come back as a false negative. So it's good to retest those on a regular basis or anytime you're testing your full thyroid panel, go ahead and add those in just so you can double check, especially if you are getting those low markers. You know, you want to keep an eye on it, where they're okay, the soldiers are present, but they're really, really, really low right now. The other component to that is that if you have symptoms, then we want to look at your thyroid values. Like, okay, we can say TBO and TJ, yeah, the present. Let's put those over here now. How's your free T3 and reverse T3? Are you diagnosed with hypothyroidism? Are you on medication? Is that medication actually optimizing you or are you just normal per conventional medicine standards? To which I always tell people listen, don't hang your hat on your antibodies. So the flip side would be what if your antibodies were a thousand, but you felt amazing, your free T3 is optimal, your reverse T3 is optimal, you have zero symptoms. Okay, then we do some work on the antibodies. We add in black human, we go gluten-free, we do those things, but we don't freak out. But this the flip side is what if your antibodies are zero, but your free T3 is in the toilet, your reverse T3 is high, your body is in survival mode, you're gaining weight like it's no tomorrow, and you are losing hair like crazy. It's time to do something about that. Like we don't care that you have zero antibodies or one or two. We need to fix this over here. So it really comes back to the most important question that anyone can ask you how do you feel? And if you feel like you have symptoms, then we need to do something about it.

Philip Pape 49:15

So if you don't have symptoms and those are low, to answer her question, like, is there a way to tell you put Hashimotas into remission?

Dr. Amie Hornaman 49:22

Only if those are zero. You put Hashimoto's into remission. Got it. If there's any antibodies present, then no, but I would say she's pretty darn close. Maybe she just needs to push it a little bit more and it'll go into full remission. But then just keep an eye on it because those antibodies respond to stress, they respond to an infection. I mean, if you get a cold over the winter, your antibodies can bounce back and appear again. So you just have to keep an eye on them.

Philip Pape 49:48

Well, Carol's a rock star. She does all the things that you tell people to do. And so even somebody like that who, you know, struggles with thyroid issues like this, it's it's the reality, right? And so understanding all this is important. Her other question is related to TSH. She's wondering how low is too low for it to be suppressed when on T3 and T4 meds. Um, her main concern is how it might contribute to osteoporosis.

Dr. Amie Hornaman 50:12

Got it.

Philip Pape 50:12

So, how do you keep TSH in a good range while on the meds?

Dr. Amie Hornaman 50:15

Oh, Carol, I love your question. Okay. So whenever you are taking a thyroid hormone replacement containing T3, you are going to get TSH suppression. And we even see TSH suppression on people that are on T4 only. Now, if we think about it, I want I want to back up, think about it from a thyroid cancer standpoint. And this is where I question the conventional medicine rhetoric of not suppressing TSH in your average hypothyroid patient when it's okay and actually targeted to suppress TSH post-thyroid cancer. So, why is it that we're purposely suppressing TSH in this population and we're freaking out and putting and using fear mongering in this population? It doesn't even make sense. On top of that, Carol, that whole osteoporosis, tachycardia, aphib thing, both of those have been completely debunked. We we do not see loss of bone when you are doing all the other things to protect your bone. Now, if you're a 75-year-old sedentary woman who doesn't eat enough protein and doesn't lift or even take a walk, and we suppress your TSH, you might get a little bit of bone loss there. Yeah, absolutely. But if you are healthy and you're doing all the things like it sounds like you're doing, Carol, then that's not really something that we worry about whatsoever. My TSH has been a 0.0007 for decades because I am on T3 only at a very high dose. And I get my DEXAs every year, almost just to kind of prove it to myself and to my audience. I mean, there's nobody else that'll listen to me out there in the scientific world. I'm like, hey, I got bones of a 25-year-old. I my TSH is non-existent. So yeah, you just have to take care of yourself there.

Philip Pape 52:11

I love it. And I like the myth busting, right? When you you some of these things persist, especially, you know, the big myths we kind of all have heard now, but something like that where it's just lurking and women are concerned about not taking treatment options because of the symptoms. It's really a relief, I'm sure, for them to hear that. So thanks for answering those, Dr. Amy. And I guess the last thing I would ask is is there anything you wish I had asked, especially in the T2 world? Because I know it's a big topic and a hot topic now. Is there anything we didn't cover you think we should?

Dr. Amie Hornaman 52:38

Oh, goodness. No, I think you covered everything. We hit all of the important points, all the studies. I I love it. I love it. And really what I would just say to your listeners is if you are struggling with weight loss, I that I mean, that's just it's it's huge, especially if you're a woman. You know, guys, I know you care about your body composition too, but man, us women are so hard on ourselves. And and we really like we get impacted where it starts affecting our social life and our bedroom life because we don't really want to get naked, because we don't feel good about ourselves, you know. So it starts creeping into other areas of our life. And I don't want people to think that you need to be in this skinny culture, but we need to be a healthy weight. So if you are struggling, just know that there is hope. There are things that you can do. And even if you are being medically gas-lit by your conventional medicine doctor, you don't have to buy into that. You don't have to believe that. You know, block that out and just have hope and know that there are things that you can do to change.

Philip Pape 53:42

Know that there are things you can do to change. That's the message right there. Dr. Amy, this has been awesome. I think T2, I mean, you I always try to bring people on who will teach me something and because I know the listener will learn something. And I will be looking into this myself as well. Right now, my biggest uh metabolism booster is I had surgery, so the recovery is actually boosted my metabolism. But after that, check it out. So, where can listeners find you? We can throw those in the show notes for people to uh to reach out and learn more about your work.

Dr. Amie Hornaman 54:10

Absolutely. So you can go to just dramey.com, D-R-A-M-I-E.com, and that's where you'll find anything. You can you can book a call on that page if you're interested in working with us and coming into the clinic where we prescribe to all 50 states. You can also find the podcast, the thyroid fixer podcast that Philip's a guest on as well. We have over 590 episodes, so tons of information there. And then I'll encourage all your listeners to join my just fix your thyroid Facebook group. So this Facebook group is, in my opinion, one of the best out there because we give real advice. I'm in there answering your questions. I'm in there once a week doing a live QA answering your questions. You can post your labs in there, you can post your symptoms in there, my nurse practitioners are in there, my coaches are in there. Like it is a free community full of love and support and to really kind of unpack what you're dealing with if you are dealing with a thyroid problem, low hormone problem, and what you can do about it.

Philip Pape 55:13

Awesome. So, drAmy.com, the thyroid fixture podcast, and the Facebook group, we will throw the links in the show notes for the listener. Dr. Amy, thank you so much for doing this with me. I'm excited to be on your show as well. We'll we'll share that with everyone when it comes out. And um, we're recording this before the holiday, so you know, I wish you the best. Thank you. Happy holidays.